Hormone Replacement therapy may help stabilise bleeding and mood changes brought on by being perimenopausal. The combined oral contraceptive pill is only used with caution for women in their later forties and fifties.
Progesterone and its derivatives (progestogens) do not reduce bleeding to any great extent, but can be useful for regulating the cycle/bleed.
Tranexamic Acid and non steroidal inflammatory drugs e.g. Ibuprofen, can help reduce the quantity of bleeding as well as pain.