---
title: "Perimenopause and menopause: symptoms and treatment"
description: "Perimenopause symptoms, HRT benefits and risks, non-hormonal options, vaginal dryness, contraception, heart health and bleeding after menopause."
url: "https://myruva.co/learn/topics/menopause"
language: "en-GB"
---

# 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.

- [Bleeding after menopause](https://myruva.co/learn/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.
- [Contraception in perimenopause](https://myruva.co/learn/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.
- [Heart health after menopause](https://myruva.co/learn/heart-health-and-menopause): How heart risk changes around menopause, which checks to ask about, and why HRT is a separate decision from preventing heart disease.
- [HRT: types, benefits and risks](https://myruva.co/learn/hrt-benefits-risks-and-types): 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.
- [Menopause and work](https://myruva.co/learn/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.
- [Non-hormonal options for menopause symptoms](https://myruva.co/learn/non-hormonal-treatments-for-menopause): CBT, fezolinetant, elinzanetant and other options for menopause symptoms, with safety checks for medicines and cautions on herbal remedies.
- [Perimenopause symptoms beyond periods](https://myruva.co/learn/perimenopause-symptoms): 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.
- [Perimenopause, menopause and after: the stages](https://myruva.co/learn/menopause-stages-explained): What the stages of menopause mean, how age and medical treatment affect them, and why missed periods alone can’t tell you.
- [Starting HRT: what to expect in the first months](https://myruva.co/learn/starting-hrt-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.
- [Vaginal dryness and genitourinary symptoms](https://myruva.co/learn/vaginal-dryness-and-gsm): How menopause can affect comfort in the vagina and when you pee, what treatments can help, and when to get symptoms checked.
- [Weight and body changes in perimenopause](https://myruva.co/learn/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.
- [What the NICE menopause guideline says](https://myruva.co/learn/nice-menopause-guideline-what-it-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.
- [Perimenopause periods: changes and care](https://myruva.co/learn/perimenopause-and-period-changes): How periods can change in perimenopause, which bleeding to get checked, when you still need contraception, and how to get support.