This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Heavy menstrual bleeding , Subject name: Gynaecology & Obstetrics
Which of the following treatments for menorrhagia is not supported by evidence? 
Select and explain. 
A. Tranexamic acid, B. Ethamsylate, C. Combined OCP, D. Progesterone
B: Ethamsylate
Answer: B: Ethamsylate 
Explanation: Ans. is 'b' i.e. Ethamsylate Ethamsylate has a dubious role in treatment of menorrhagia. Tranexamic acid, progesterone and combined OCP, all have proven role in treatment of menorrhagia."Ethamsylate is thought to act by reducing capillary fragility, though the precise mechanisms are uncertain. Studies with objective MBL (menstrual blood loss) measurement using the currently recommended doses show that it is ineffective" - DewhurstsRest of the two books mentioned in reference do also mention that efficacy of ethamsylate in reducing menstrual blood loss have not been satisfactorily proved. Its use is not recommended in UK.