Hi Tc,
I also don't understand the term 'back-titration' in this context because one cannot reduce the dose bit by bit when the only option is to decrease one spray...
Tbh I think this is just a mistranslation from Hungarian and it might be corrected in the future. It happens a lot to PILs.
Regarding the reasoning behind reducing back, I think there are 2 possibilities.
1. Estradiol (an other steroids) usually exhibit an inverted U or U-shaped dose-response curve in the hippocampus, amygdala and hypothalamus, meaning low doses and high doses might elicit the same response whereas medium doses might give a different (and usually better) response.
2. One can't keep increasing the dose, so the only way forward is to go back to previous dose and give more time so the body can adjust to hormone levels or switch to a different treatment.
Bottom line: trial and error and everyone is different 😁
BeaR.
Edited: not 'pump', 'spray'