I'v been having heavy, painful menstrual bleeding for about a year now (age 42). What can be done?

Several. 1. Several types of medications including including birth control meds. 2. A medication that increases the clotting and decreases the bleeding. 3. Mirena (levonorgestrel) iud. 4. Endometrial ablation. 5. Fibroid embolization if you have fibroids. 5. Hysterectomy.