Sarah West I Certified ADHD Coach, Exeter (2026)

04/05/2026

When perimenopause hit my undiagnosed ADHD brain, I thought I was losing myself. Every month, I talk to women who’ve had the same experience.

Perimenopause has a profound effect on ADHD and we had no idea that the two were intrinsically connected.

Oestrogen is essential for how the brain makes and regulates dopamine. When it fluctuates and drops during perimenopause, it affects far more than night sweats and brain fog.

For women with ADHD, it pulls apart everything the brain has been relying on to function.

Focus goes, emotional regulation disappears, anxiety that was manageable becomes anything but, sleep becomes non-existent, strategies and routines that worked for years stop working.

Women spend months, sometimes years, being told they're depressed or anxious. The clinicians looking after them often don't know the connection exists, so nobody explains it.

This Wednesday 6th May I'm presenting my monthly ADHD UK webinar on exactly this from 12-1pm.

I'll be covering:

-What your hormones are doing and why supporting them is particularly important if you have ADHD
-Why so many women are recognising their ADHD for the first time in perimenopause
-Which areas of life are most affected when the two collide
-What you can do about it

Understanding what is going on is the first thing that helps.

If you have ADHD and perimenopause is making everything harder to manage, I’d love you to join me.

Registration is through the ADHD UK website. Link is in the comments.

03/05/2026

I had a serious eating disorder for fifteen years. I had no idea it was linked to ADHD.

I was a teenager when it started. I got through it without anyone helping me understand what was behind it.

And even after I recovered, I carried so much shame and guilt that I didn’t speak about it for years.

It wasn't until my ADHD diagnosis that I started to join the dots.

ADHD and neurodivergence are increasingly recognised as linked to disordered eating and eating disorders.

The dopamine-seeking brain, the difficulty with impulse control, the emotional dysregulation, the need to self-regulate in a world that never felt designed for you: these are the reasons food becomes the thing you turn to when everything else feels overwhelming.

When people talk about addictions we might think of alcohol, drugs or gambling. We rarely talk about food, and when we do, we talk about willpower and self-control.

For many of us, it was never about either of those things.

I think of so many women I've known who have struggled with food their whole lives. And I wonder how many of them were neurodivergent and never knew it.

Has your ADHD diagnosis changed how you understand your relationship with food?

28/04/2026

I always knew I was different. I just had no idea why.

I spent years trying to be what everyone else seemed to be. I watched people living their lives without the constant stress I felt everywhere.

Time blindness, oversharing at completely the wrong moments, overthinking and emotional dysregulation, to name but a few.
I never felt like I fitted in anywhere.

Things that seemed effortless for everyone else took everything I had.

I was always the anxious one. The one who had to work twice as hard just to keep up, and was constantly apologising for merely existing.

I didn't know any of that was ADHD. I just thought I was the problem because I'd lived my life feeling that I was either too much or not enough.

So when people started calling ADHD a "superpower," it felt like someone who had never lived my life was telling me it was a gift.

And to be honest, that felt insulting.

The su***de rate for people with ADHD is significantly higher than for those without it. Up to 70% of the prison population is estimated to have ADHD. Financial difficulties, emotional dysregulation, relationship breakdowns, addictions, eating disorders.

These are the real ADHD stories I hear everyday.

Superpowers don't do that.

Yes, there are genuine strengths that come with an ADHD brain. I know that first-hand.

But wrapping the whole thing in a bow and calling it a gift does something damaging. It makes the people who are genuinely struggling feel like they're even doing THIS wrong.

Have you ever heard anyone say, "I wish I had ADHD"?

Millions of people have spent their lives being failed by systems that didn't understand their brains. Working twice as hard and being told the problem was them.

That is not a superpower story.

How do you feel when people tell you your ADHD is a superpower?

25/04/2026

I sat in front of my GP and felt like such a fraud trying to explain what was going on.

It was clear they didn't understand how ADHD presents in women. And when I raised the perimenopause, I was told I needed a blood test to confirm it.

(Newsflash: That's not how perimenopause is diagnosed).

Maybe you're newly diagnosed with ADHD, or you're trying to get a referral for an assessment. And you know something has changed. The anxiety, the emotional dysregulation, the anger, the exhaustion. You know this isn't just stress.

But when you try to explain it, it comes out wrong, or incomplete, or like you're being dramatic.

And then you're told you're too young to be in the perimenopause. Or that you can't have ADHD because you've held down a job and been in higher education.

Both of those things are wrong.

ADHD and perimenopause share more symptoms than most clinicians realise. When the two overlap, it becomes genuinely hard to know where one ends and the other begins. And without the language, you can't ask for the right support.

That's why I have TWO FREE RESOURCES for you:

• A symptoms checklist and diagnosis guide for ADHD, perimenopause and menopause.

• A guide to understanding how your hormones are affecting your ADHD.

Both are written to help you make sense of what's happening, so the next time you're sitting in that appointment, you know exactly what you need to say.

Download both at the link in the comments.

What's the one symptom you've found hardest to explain to a clinician?

23/04/2026

A wonky bowl just taught me something that decades of trying to be perfect couldn't.

I joined a pottery class for fun. Last week I made a bowl with a thumbprint pressed into the clay and uneven sides.

I think it might be my favourite thing I've made.

Because it reminded me of something I'd spent most of my life not understanding.

That good enough is good enough.

For many late-diagnosed women with ADHD, perfectionism was never a choice. It was the standard we set for ourselves without realising it.

We watched how other people seemed to manage things easily and told ourselves we needed to be organised, consistent, capable, liked, and not criticised.

We became people pleasers. We held ourselves to standards that were never even real.

And when we didn't meet them, we didn't question how impossibly high those standards were.

We told ourselves we had failed.

Not that the bar was too high. Not that it was never realistic.

That we were the problem.

We held that for years. Sometimes decades. Before we understood that perfect doesn't exist and never did.

Trying to live up to a version of yourself that was never you is exhausting.

The bowl doesn't know it's wonky. It holds things. That's what it's for. It does exactly what it's supposed to do, in its own individual way.

And I bloody love it for that.

Good enough IS good enough. Not only in pottery but in being exactly who I am, whether I'm wonky or not.

When is good enough, good enough for you?

21/04/2026

Getting an ADHD diagnosis often doesn't just explain the ADHD. It starts explaining everything else too.

ADHD rarely exists on its own. Research suggests that if you have one of the conditions below, you're likely to have at least two or three others. I see this consistently in my work, and I've experienced it personally with both myself and my neurodivergent children.

These are the most common co-existing conditions:

Hormone-related
• Premenstrual Dysphoric Disorder (PMDD)
• Postnatal depression
• Perimenopause and menopause
• Endometriosis/Adenomyosis (emerging evidence)

Neurodevelopmental
• Autism (AuDHD is far more common than many realise)
• Dyslexia, dyspraxia, and dyscalculia
• Sensory Processing Disorder
• Tourette's and tic disorders

Mental health
• Anxiety disorders
• Depression
• Rejection Sensitive Dysphoria (RSD)
• OCD

Sleep
• Insomnia
• Obstructive sleep apnoea
• Restless legs syndrome

Physical health
• Fibromyalgia
• ME/CFS
• Irritable Bowel Syndrome
• Ehlers-Danlos Syndrome (particularly hypermobile type)
• Migraine
• POTS
• Raynauds
• MAST cell activation syndrome
• Long COVID (emerging evidence)
• Inflammatory conditions including asthma

Compulsive and addictive behaviours
• Substance use disorders
• Compulsive behaviours including shopping, gaming, and gambling
• Disordered eating patterns

Recognising these overlaps changes what support looks like. It means people stop being treated for individual symptoms in isolation and start getting the joined-up understanding they deserve.

Full references are in the comments.

Does any of this reflect your own experience?

19/04/2026

I am angry.

Properly, unapologetically angry.

I was dismissed and gaslit for decades before anyone connected the dots. Before anyone understood that the exhaustion, the feeling that everyone else had been handed a manual I never received, all of it had a name. And a reason.

When I look at the women I work with now, I see the same story playing out again and again.

We are still being let down.

Too many clinicians still don't understand how ADHD actually presents in women and girls.

-They don't understand how hormones directly affect how we make and regulate dopamine.

-They don't understand how perimenopause and ADHD interact and amplify each other.

-They're trying to rule out perimenopause with a blood test when that isn't how it's diagnosed.

-And they're still working from ADHD diagnostic criteria built around boys that has never fully accounted for women.

This is not a niche problem. This is millions of women being told the wrong thing, being given the wrong diagnosis, being sent home with antidepressants, and being failed year after year.

That anger has become my mission.

I'm a former senior NHS nurse and a trained ADHD coach and assessor. I've lived this from the inside, both as a clinician and as a woman who nearly lost everything before she understood what was happening to her.

That combination is rare. And I am not going to waste it.

This is the hill I will die on.

I want to help train clinicians. I want GPs, psychiatrists, menopause specialists, and nurses to understand how to recognise this and properly support women, rather than sending them home with an anxiety diagnosis and a prescription.

A lot of this isn't complicated. It just needs someone to teach it.

We know ourselves better than any clinician who has seen us for ten minutes. We shouldn't have to fight this hard to be believed.

That changes when the people treating us truly understand us.

What's your experience been of trying to be understood by the medical system?

16/04/2026

You waited years for your ADHD diagnosis.

And when it finally came, they handed you a leaflet and closed the door.

This is one of the most significant ways the system is failing people right now. And it doesn't start at diagnosis. It starts before it too.

Go to your GP and say you think you have ADHD. What happens?

At best, a referral to a waiting list that could take years. At worst, a leaflet for a generic talking therapy service that was never built for a neurodivergent brain.

Unless support is neuro-affirming, from a practitioner who understands how the neurodivergent brain works, it will not help.

CBT, counselling, therapy — all of it needs to be delivered by someone who understands how an ADHD brain works. Not through a neurotypical lens that pathologises the way we think, feel, and function.

When I got my ADHD diagnosis, I had so many questions. What does this mean for me? Where do I go from here?

The door just closed.

There are no reliable NHS pathways that offer:

• Psychoeducation about what ADHD means for you specifically
• Neuro-affirming coaching or therapy
• Support while you're still waiting for assessment
• Proper medication review and monitoring
• Practical guidance on work, relationships, and daily life

Treating an ADHD brain with neurotypical support is like having a kidney problem and being treated for a broken leg.

It will never work. But it costs the NHS an enormous amount of money in repeated, incorrect interventions while people's lives and careers fall apart around them.

The demand is there and it’s here to stay.

The support has to catch up.

What happened after you got your diagnosis?

15/04/2026

For decades, ADHD had one face.

A hyperactive boy at the back of a classroom. Disruptive. Unable to sit still. Impossible to ignore.

It was never a girl.

The early research into ADHD was conducted almost exclusively on boys. The diagnostic criteria were built around what ADHD looked like in boys. Externally obvious. Loud. Disruptive.

Girls present differently.

We internalise. We mask. We work twice as hard to appear as though everything is fine. We are not disruptive. We are not noticed.

The UK didn't formally recognise ADHD in children until the 2000s. Adults weren't included until 2008. Women and girls with their own specific presentations? We're still catching up on that now.

For generations, women with ADHD were told they had:

• Anxiety
• Depression
• Emotional instability
• A personality disorder
• Just stress

Anything except the actual answer.

Many of us only found out the truth when our children were assessed. Or when perimenopause hit and the masking that had held everything together for decades finally stopped working.

The stereotypes haven't gone away. Some GPs still believe ADHD is something hyperactive boys have. Not something that can be a woman in her 50s who held down a career, raised children, and looked completely fine. When in reality, she was struggling with everything.

The gap between male and female diagnosis is not a gap in how often ADHD occurs in women.

It is a gap in how well the medical system was built to see us.

Does this reflect your own experience of trying to get answers?

14/04/2026

Last summer I stood in a tent at the Beautiful Days festival and looked out at more than 200 people. And that was just the ones who'd managed to get inside.

People were standing outside watching through the entrance because there wasn't room. The organisers told me that in over twenty years of the festival running, my talk had drawn more interest than any they'd hosted before.

I was talking about ADHD. What it actually is, how it presents in women, why so many of us spend decades undiagnosed, and the connection between ADHD and perimenopause that most people have never been told about.

By the end, people were in tears. Not because the content was bleak, but because for many people in that tent it was the first time someone had put into words what they were living through. Messages started coming in before I'd even left the site.

Professionals who watched got in touch to bring this conversation into their own settings. People became clients because what they heard finally made sense of their lives. I was booked to speak at Beautiful Days again this year before I'd packed up.

Not a polished presentation or a slide deck of statistics. An honest, evidence-informed discussion about what it means to live with ADHD, and why so many people spend years being told they're lazy, difficult, or just not trying hard enough before they ever get an explanation.

If you run a festival, a workplace wellbeing event, a retreat, or a conference and this is the conversation your audience needs, I'd love to hear from you. The YouTube recording is in the comments.

13/04/2026

I want to push back on something I hear quite often.

"I don't like labels."

I understand it. Labels can feel negative, like you're being handed a list of limitations. But I want to offer a different perspective, because for me and for a lot of the women I work with, getting a label was one of the most significant and validating things that ever happened to us.

Before my ADHD diagnosis, I genuinely didn't know what was wrong with me. There was a point where I thought I might have bipolar disorder because I knew of no other explanation to why I thought and acted the way I did.

Things would be impossible one day and manageable the next, emotional dysregulation and what I perceived as rejection from others could floor me for days, and overwhelm was never far away. I struggled with things that everyone else seemed to manage without thinking.

I had spent decades believing this was a character flaw. A personal failing. Something fundamentally wrong with me that I just needed to try harder to fix.

The label of ADHD didn't put me in a box. It explained the box I'd been living in my whole life.

It helped me understand how my brain actually works.

It meant I could start to get the right support, instead of being failed by systems that didn't understand neurodivergence. It gave me a framework where there had only ever been confusion.

The word "label" has taken a bit of a battering lately. And I'm not here to tell anyone how to feel about their own diagnosis.

If labels aren't for you, that's your personal choice and I respect it completely. Just know that for a lot of us, it wasn't a label at all. It was an explanation.

And for some of us, it saved our lives.

12/04/2026

A client said to me recently: I don't understand what happened. I managed for years. And then in my mid-40s everything just fell apart.

She's not alone. I hear this every week.

There's a specific biological reason why ADHD that felt manageable for years can become suddenly unmanageable during perimenopause, and it comes down to oestrogen.

Oestrogen plays a direct role in the production and regulation of dopamine and serotonin — the neurotransmitters responsible for focus, motivation, mood, and emotional regulation. During perimenopause, oestrogen levels begin to decline, and as they do, so does their support for these systems.

For a neurotypical brain, this is challenging. For an ADHD brain, it compounds an existing problem. ADHD is fundamentally a condition of dopamine dysregulation. The ADHD brain has always had to work harder to regulate dopamine effectively. When oestrogen withdraws that support, the system becomes even less stable.

The result: symptoms that were masked and managed for decades can suddenly feel impossible to contain. Executive function that was fragile but functional becomes unreliable. Emotional regulation that required constant effort becomes harder still. Brain fog that was occasional becomes constant.

This is not a personal failing. It's not anxiety. It's not depression, though those often follow. It's a neurobiological event that the vast majority of clinicians are not trained to recognise or connect.

If your ADHD got significantly harder to manage in your 40s, this is likely why. And knowing why matters, because it changes what support you actually need.

Did your ADHD symptoms change during perimenopause, and did anyone ever explain why?

Sarah West I Certified ADHD Coach

04/05/2026

03/05/2026

28/04/2026

25/04/2026

23/04/2026

21/04/2026

19/04/2026

16/04/2026

15/04/2026

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13/04/2026

12/04/2026

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