Perimenopause and menopause: symptoms and treatment

What changes, what helps, and how UK and US guidance differ, including HRT, other treatments, and which symptoms always need checking.

5 min read Bleeding after menopause Why even a little bleeding after menopause needs checking, what the checks may involve, and how HRT changes things. Includes when to get help.
4 min read Contraception in perimenopause You can still get pregnant in perimenopause. Compare UK and US advice on stopping, choosing a method and using it with HRT.
4 min read Heart health after menopause How heart risk changes around menopause, which checks to ask about, and why HRT is a separate decision from preventing heart disease.
5 min read HRT: types, benefits and risks How types of HRT and ways of taking it differ, what HRT can help with, and how UK advice on risk compares with recent US label changes.
4 min read Menopause and work Practical ways to ask for changes at work, talk about symptoms, and understand the main UK and US protections. Includes when to get help, with UK and US notes.
5 min read Non-hormonal options for menopause symptoms CBT, fezolinetant, elinzanetant and other options for menopause symptoms, with safety checks for medicines and cautions on herbal remedies.
4 min read Perimenopause symptoms beyond periods How perimenopause can affect sleep, mood, joints and your bladder, what to write down, and when to get help. Includes when to get help, with UK and US notes.
4 min read Perimenopause, menopause and after: the stages What the stages of menopause mean, how age and medical treatment affect them, and why missed periods alone can’t tell you.
8 min read Starting HRT: what to expect in the first months Which side effects and bleeding are common early on HRT, what the 3-month review is for, and which bleeding to get checked sooner.
4 min read Vaginal dryness and genitourinary symptoms How menopause can affect comfort in the vagina and when you pee, what treatments can help, and when to get symptoms checked.
6 min read Weight and body changes in perimenopause Why your middle can change in perimenopause, what's known about HRT and weight, and why strength and steady eating help more than strict diets.
5 min read What the NICE menopause guideline says A plain guide to NICE advice on diagnosis, CBT, the risks of HRT and fezolinetant, with the main UK and US differences. Includes when to get help.
5 min read Perimenopause periods: changes and care How periods can change in perimenopause, which bleeding to get checked, when you still need contraception, and how to get support.

Written by the Ruva team from the sources listed in each guide. They aren’t medical advice. If you’re worried about a symptom, talk to a doctor, nurse or pharmacist.