I dont see how it costs the practice as most of the ladies pay twice for their prescriptions.
Also we only get 3 months worth which if you go via the posted costs, unless we are on the most expensive options then we are almost paying for our HRT treatments fully.
The options you have is to get a prog option from doc every year or 6 months. After taking the prog you should have a period.
Then continue with the tibolone as normal.
That way you would not have any build up.
Please bare in mind that many ladies will go into Meno blissfully unaware of any buildup as they are not screened for this.
If our normal prog levels drop but we are still producing estrogen then there will be a build up naturally even without HRT/Tibolone.
So if the doc's try and blame the HRT/Tibolone then please correct them