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[Casey65]

Hello, ladies!
I am a first time poster but a long time reader of the MM forum. I've recently read that ladies in UK are willing to use dydrogesterone in combination with transdermal estradiol, but they do not have this option because Duphaston had been discontinued in the UK years ago.
https://www.menopausematters.co.uk/forum/index.php?topic=43552.15

I can buy Duphaston in my country and I am now trying to find out how to use it in a continuous regime with Lenzetto spray (1.53 mg estradiol per spray). I do want continuous and NO bleed MHT, with transdermal estradiol. I am 56, post meno, and have been on Angeliq (estradiol 1 mg + drospirenone 2 mg) for almost 2 years with good results but it is not available anymore.

The Duphaston (10 mg dydrogesterone) leaflet states:
"For hormone replacement therapy: In combination with continuous oestrogen therapy, take one tablet daily for 14 consecutive days of a 28 day cycle.
In combination with cyclical oestrogen therapy, take one tablet daily during the last 12 to 14 days of oestrogen therapy."

It doesn't look as a progestogen continuous approach if taken for 14 days only. Would it cause a monthly bleed in this case?

The only reference to this conti combination I've found here https://www.degruyter.com/document/doi/10.1515/hmbci-2018-0033/html
and it gives, in Table 6, the daily dose of different progestogens, according to number of transdermal E2 Lenzetto sprays. For Dydrogesterone, the daily dosage for the conti scheme is:

One Lenzetto spray: 5(-10) mg
Two Lenzetto sprays: 10 mg
Three Lenzetto sprays: 20 mg

Another study found here https://pubmed.ncbi.nlm.nih.gov/11173181/ says, regarding ORAL continuous therapy with 17beta-oestradiol (1 or 2 mg) and dydrogesterone:
For endometrial safety "the success rate was 97%, 97% and 98% in women receiving 1/5, 1/10 and 1/20 mg, respectively, and 95%, 98% and 91% in women receiving 2/5, 2/10 and 2/15 mg, respectively."

I am a bit confused and I am hoping someone here might give a piece of advice on how to take a conti Lenzetto + Duphaston. I have a doc appointment next month and I want to be prepared with a suggestion on this line (so far I have been offered only oral sequi schemes, which I do not want to try).

As one Lenzetto spray is 1.53 estradiol, how much Duphaston to take daily with one and with two sprays?

Thank you so much and looking forward to your thoughts on the matter.