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E.EfronN.GalorA.et al (2023)

Buyers should compare the original five-vial presentation and traceability rather than an isolated per-vial price

Procedures for Vascular Causes Patients with symptoms and imaging findings consistent with pelvic congestion syndrome or pelvic venous disorders may benefit from referral to interventional radiology for evaluation of endovascular treatment options

So the real question is not: Do supplements work, yes or no? It is: Which ingredients have meaningful evidence, in whom, for what purpose, and with what expectations? That is a much smarter question and a much better way to choose a formulation