\begin{tikzpicture}[node distance=2cm]
\usetikzlibrary{shapes.geometric, arrows}
\tikzstyle{every node} = [rectangle, rounded corners, text centered, minimum height = 0.8cm, draw=black, fill=red!30]
\tikzstyle{arrow} = [thick,->,>=stealth, rounded corners]
\node (mm) {Main Menu};
\node (sm) [below of=mm, xshift=-3cm] {Settings Menu};
\node (sg) [below of=mm, yshift=-1cm] {Start Game};
\node (em) [below of=mm, xshift=3cm] {Exit Game};
\node (gp) [below of=sg] {Gameplay};
\node (pm) [below of=gp] {Pause Menu};
\node (sgm) [below of=pm] {Settings Menu};
\draw [arrow] (mm.west) -| (sm.north);
\draw [arrow] (sm.east) -| ([xshift=0.3cm]mm.south west);
\draw [arrow] (mm) -- (sg);
\draw [arrow] (mm.east) -| (em.north);
\draw [arrow] (sg) -- (gp);
\draw [arrow] (gp) -- (pm);
\draw [arrow] (pm) -- (sgm);
\draw [arrow] (sgm) -- ++(-2,0) -- ++(0,2) -- (pm);
\draw [arrow] (pm.east) -- ++(4,0) -- ++(0,7.22) -- ([yshift=0.22cm]mm.east);
\draw [arrow] (em.south |- pm.east) -- (em.south);
\end{tikzpicture}