Sarah West I Certified ADHD Coach

When perimenopause hit my ADHD brain, everything I'd always managed to keep together fell apart. I no longer recognised myself.

Since then, I've supported hundreds of women who've told me almost exactly the same story.

Is this ADHD? Is this perimenopause? Is it both? Why has everything suddenly become so much harder?

That's exactly why I'm so pleased to be speaking at this face to face event at The Exeter Phoenix this September.

It brings together my work as an ADHD coach, my background as a nurse, and my own lived experience of ADHD and perimenopause.

If you're able to get to Exeter on Thursday 3rd September at 6.30pm, I'd love to see you there.

I'll be covering:
-Why ADHD often presents differently in women,
-Why so many first recognise it during perimenopause
-What hormonal changes are actually doing to the ADHD brain.
-Why so many of us were told it was just anxiety, stress or getting older
-How it affects work and relationships
-How to access the right support
-What changes we can make in our lives to help

More than anything, you'll leave with answers:
-A better understanding of what's happening in your own brain
-Knowing where to go next
-More confidence advocating for yourself, whether that's with your GP, at work or with the people around you.

Answers that many women spend years trying to find on their own.

📅 Thursday 3rd September
🕡 6.30pm
📍 Exeter Phoenix
🔗 Link to sign up in the comments

There'll be plenty of time for questions if you have them.

So if there's something you've always wanted to ask about ADHD, perimenopause, hormones, assessments or ADHD support, then grab your spot here.

Book your place soon as spaces are limited.

There's been a lot of discussion recently about the upcoming Channel 4 documentary, ‘The Great ADHD Myth’.

For me, it raises a much bigger question about the responsibility of broadcasters and journalists when reporting on ADHD.

ADHD is not just a topic for debate. It's a recognised neurodevelopmental condition, supported by decades of research, and it is not something created by social media, screens or modern life. Behind every conversation about it are real people whose lives are affected by whether they are understood, supported or dismissed.

There are important conversations to have about ADHD, including how we improve diagnosis, access to timely assessment, and evidence based care and support.

Good journalism looks at the whole picture. It explores the evidence rather than simply presenting controversy, it challenges claims with counter evidence, and it includes the voices of people who live with ADHD rather than making sweeping statements about whether their experiences are valid.

When ADHD isn't recognised or supported appropriately, the consequences are often significant.

It affects mental health, education, employment, relationships and quality of life. Delayed recognition and inadequate support also place greater pressure on healthcare, education and social care systems. Misinformation doesn't just influence opinion, it has real world consequences for individuals and for society.

Questioning healthcare matters. Improving it matters more. But reducing an evidence-based neurodevelopmental condition to a debate about whether it even exists risks increasing stigma, creating confusion, and making it even harder for people to access appropriate support.

Journalists, broadcasters and anyone with a public platform have a responsibility to report accurately, reflect the evidence, include nuance, and consider the impact their words have on the people living with the condition they're discussing.

Public conversations about ADHD should inform, educate and encourage understanding. They should be grounded in evidence, reflect the complexity of ADHD, and remember that behind every headline are real people whose lives are shaped by the stories we choose to tell.

I was sat at my desk when I opened my second autism assessment report last week. I didn't cry. I didn't feel shocked. I just felt calm.

A year earlier, a different clinician had told me I didn't meet the DSM-5 criteria to be diagnosed with autism. This report said I did.

The information I'd shared about myself and my life hadn't changed between the two assessments. What was different was how it was interpreted, and that the first clinician hadn't understood how autism presents in women and girls.

Maybe the second assessment would have reached the same conclusion as the first. If it had, I'd have accepted that. What mattered was knowing my experiences had been fully understood and fairly considered.

Years ago, I'd probably have accepted the first outcome, even though it didn't feel right. I was the classic people pleaser. I'd have smiled, said okay, gone home, and spent months trying to work out why my whole life felt so connected to autism if I didn't meet the criteria.

This time was different. I trusted myself enough to know I needed more answers than I had. My GP listened and referred me for a second opinion.

Reading that second report, I could finally see my whole life mapped against the criteria clearly enough to recognise myself in it. That's why I felt calm. Not shock, just recognition.

Clinical judgement is a real part of diagnosis. Two experienced clinicians can hear the same information and interpret it differently.

That doesn't mean one is always right and the other wrong. But it does mean it's okay to ask questions if an outcome doesn't reflect your lifelong experience.

Trust yourself. Not because you know more than the professionals assessing you, but because you're the expert in your own lived experience. It's okay to ask for an explanation, to seek clarity, and sometimes to ask for a second opinion if you feel this is needed.

Self-advocacy isn't about proving someone wrong. It's about making sure your voice is heard, because sometimes that changes everything.

When perimenopause hit my ADHD brain, everything in my life that I'd previously managed to keep together fell apart. I no longer recognised myself.

Since then, I've supported hundreds of women who've told me almost exactly the same story.

Is this ADHD? Is this perimenopause? Is it both? Why has everything suddenly become so much harder?

That's exactly why I'm so pleased to be speaking at this face to face event at The Exeter Phoenix this September.

It brings together my work as an ADHD coach, my background as a nurse, and my own lived experience of ADHD and perimenopause.

If you're able to get to Exeter on Thursday 3rd September at 6.30pm, I'd love to see you there.

I'll be covering:

-Why ADHD often presents differently in women,
-Why so many first recognise it during perimenopause
-What hormonal changes are actually doing to the ADHD brain.
-Why so many of us were told it was just anxiety, stress or getting older
-How it affects work and relationships
-How to access the right support
-What changes we can make in our lives to improve symptoms

More than anything, you'll leave with answers: a better understanding of what's happening in your own brain, knowing where to go next, and more confidence advocating for yourself, whether that's with your GP, at work or with the people around you. Answers that many women spend years trying to find on their own.

📅 Thursday 3rd September
🕡 6.30pm
📍 Exeter Phoenix
🔗 Link to sign up in the comments

There'll be plenty of time for questions if you have them.
So if there's something you've always wanted to ask about ADHD, perimenopause, hormones, assessments or ADHD support, then grab your spot here. Book your place soon as spaces are limited.

I was in a team meeting when someone started clicking their pen, and within a minute I couldn't tell you a single thing anyone else had said.

It felt like a tug of war between me and that clicking. And the clicking won every time.

I've always noticed sounds more than most people seem to. But when I reached perimenopause, it felt like someone had turned the volume up on everything. Once my brain locked onto a sound, chewing, breathing, a pen clicking, nothing else got a look in.

There's actually a word for this. Misophonia.

Specific sounds trigger a reaction that's much bigger than irritation: anger, disgust, an overwhelming urge to leave the room.

At the time, I had no idea this could be linked to ADHD. Sensory sensitivity is common in ADHD, even though it's not part of the official diagnostic criteria, and misophonia specifically is more common in people with ADHD and autism than in the general population. The brain struggles to filter certain sounds out as background noise, so they demand your attention instead.

For many women with ADHD, everything changes during perimenopause. Fluctuating oestrogen affects the same systems involved in attention and emotional regulation. The sensitivity was often already there, but there's now far less capacity to compensate for it.

The sound of someone breathing too loudly can create anger that feels utterly disproportionate, and knowing that doesn't make it any easier. It isn't really about the person breathing, it's a nervous system reacting to input it is struggling to filter out.

Understanding why something is happening doesn't make it disappear, but it helps to know it's because your brain is processing things differently.

Once you understand what's going on, you stop asking yourself, "Why am I reacting like this?" and start asking, "What would help right now?"

Sometimes it's moving seats. Sometimes it's taking five minutes outside. Sometimes it's sleeping in separate rooms when snoring has become unbearable. Small changes can make a much bigger difference than you might expect.

Has your sensitivity to noise changed since perimenopause?

For years, you've wondered why life seems so much harder for you than it does for everyone else.

You've blamed yourself for being too emotional, too sensitive, disorganised, forgetful, or convinced yourself that if you could just try a bit harder, you'd finally get on top of things.

Then perimenopause arrives.

The strategies that somehow kept everything ticking along suddenly stop working. The brain fog gets worse, the overwhelm feels relentless, and you're left wondering what's happened to the person who used to just about manage.

Then, for the first time, you begin to wonder whether ADHD could explain it.

Over the following weeks and months, you start joining the dots.

You start reading.

Listening to podcasts.

Completing screening questionnaires.

Joining online communities.

For the first time, you're reading about experiences that sound like your own. It's emotional, because after years of searching for answers, things finally start to make sense.

It isn't just a label.

It's the explanation you've been searching for.

The explanation that replaces years of self blame with understanding.

So you share your diagnosis with someone you trust.

Someone you hope will understand why this matters so much.

And they reply...

"Everyone's a bit like that."

They probably don't mean to dismiss your experience.

But that's exactly how it can feel.

Because they haven't just dismissed ADHD.

They've dismissed the explanation that finally helped you understand yourself after years of wondering what was wrong with you.

That's why those words can hurt so much.

Have you ever opened up about your ADHD journey, only to feel that someone didn't understand why it mattered so much?

Many of us with ADHD have had lifelong challenges around food and nutrition.

We know how important they are, but all too often we get caught out by either skipping meals because we’ve forgotten to eat, find ourselves frequently reaching for processed snacks without really thinking about it, or spend too long feeling guilt and shame because we can't seem to stay on top of planning, following recipes or eating the foods we feel we should.

Then perimenopause arrives.

At this point, supporting our brains becomes even more important.

Fluctuating hormones can make planning, motivation, energy and executive functioning even harder. Understanding what your brain needs is one thing. Actually making it happen when you're exhausted and trying to juggle work, family life and everything else is something completely different.

That's exactly why I was so pleased to welcome nutritionist Jen Moon as a guest speaker to one of my ADHD group coaching sessions last week.

Her presentation was brilliant. What I loved most was how practical it was. She has a way of explaining the science without making it feel overwhelming.

There was no guilt, no unrealistic expectations and no focus on perfection, just straightforward, evidence based advice that felt genuinely achievable.

Jen is the author of Nutrition for ADHD. Her book explains the science behind how food can help or hinder ADHD in a way that's easy to understand. It covers everything from protein, blood sugar and nutrients that support brain health, to hormones, supplements and practical strategies and recipes that make eating well feel much more achievable.

Understanding how food and nutrition affects our ADHD brains, particularly during perimenopause, is one of the most important things we can do.

We spend a lot of time talking about ADHD medication, but nowhere near enough time talking about the everyday things that also help our brains and bodies function better, including nutrition.

Good nutrition shouldn't become another stick to beat yourself with. It's about understanding your brain, not aiming for perfection.

Have you found changing your diet has made a difference to how you function each day?

I've lost count of the number of women I work with who are signed off sick, or caught up in formal grievance procedures, not because they aren't capable of doing their job, but because nobody recognised what they needed.

Many of these women have spent years building successful careers. They've coped, masked and worked incredibly hard to get where they are. Then perimenopause arrives, hormones begin to fluctuate, ADHD symptoms become much harder to manage, and suddenly the strategies they've relied on for years stop working.

Their confidence disappears, they're making mistakes they've never made before, struggling to keep up, and wondering what's happened to the person they used to be.

Too often, they're blamed, performance managed, or they leave jobs they once loved, before anyone considers whether ADHD and perimenopause could be part of the picture.

This was one of the biggest topics we talked about when I was invited to speak on a panel in Bristol last week about supporting neurodivergent people in the workplace.

We talked about what genuine support at work can look like, not the version that sits in a policy document nobody reads.

Often it isn't about big changes. It's about managers understanding what neurodivergence actually looks like, recognising that it presents differently in different people, and creating an environment where employees don't have to constantly explain, justify or mask the way their brain works.

The reality is that neurodivergent employees are often some of the most dedicated, hardworking and creative people in an organisation. When managers have the knowledge and confidence to recognise neurodivergence and respond well, everybody benefits. When they don't, it costs organisations time, money and talented people who should never have reached the point of burnout, long term sickness, or leaving their job in the first place.

So many of the women I support don't want to be treated differently. They don't want to be singled out. They simply want to be understood, so they can get on with doing the job they're more than capable of doing.

Decent support is rarely expensive or difficult. It starts with understanding neurodivergence, asking someone what they need, believing the answer, and recognising that there is no one size fits all.

What would support in the workplace have looked like for you if your employer had understood and supported your ADHD better?

You've opened another article about perimenopause and it doesn't mention ADHD. Again.

Or you've found something about ADHD and there's no mention of hormones, no acknowledgment that the perimenopause exists, let alone that it changes everything for a brain like yours.

That gap is exactly what my monthly newsletter is written for.

Each month I share honest reflections from my own experience of living with ADHD through the perimenopause, alongside clear information about what's happening in your brain and body when the two intersect. New blog posts, practical insights from my coaching work, upcoming events and webinars, and resources you can use straight away.

It's a space built for women who need real information and honest company. Not another list of generic tips.

If that sounds like what you've been looking for, the link to sign up is in the comments.

What made you start looking for information about ADHD and the perimenopause?

Sign up here: https://sarah-west-adhd-coach.kit.com/newsletter

Website: www.sarahwest-adhd.com

For years I ran on what felt like 3% battery, and tried my best to make sure nobody could tell.

I assumed that everyone else felt utterly exhausted each day and that having a break was something you earned. So I brushed off what my body and nervous system were trying to tell me, pushed through, told myself to focus, told myself everyone was tired, told myself I was making excuses. This worked, until it didn't.

I felt lazy and ashamed when my energy started to flag during the day, even though I knew a short rest had such a positive impact on my energy and what I could get done. I didn't think anyone else felt like this, and was too embarrassed to tell anyone.

The world we're operating in wasn't built for neurodivergent nervous systems. It rewards constant output, always being productive and looking fine, even when you are feeling the very opposite. So we override our own warning signals early, and keep going long after there's nothing left in the tank.

That exhaustion was never a weakness. It was information.

Our executive functions, initiating tasks, planning and prioritising, organising, time management, memory, staying on task, all run on dopamine, which our brains are already struggling to utilise properly. Add in sleep deprivation, which disrupts that same dopamine system even further, and everything gets harder still.

Oestrogen regulates how dopamine gets produced and used in the brain, so as it fluctuates and drops through perimenopause, that dopamine becomes even harder to rely on, and every one of those executive functions costs more effort for the same task. That's why exhaustion runs so much deeper than normal tiredness, and why a nervous system can end up stuck in survival mode with nowhere left to go.

Noticing when your energy is dropping, stopping before you hit the wall rather than after, treating your limits as information rather than proof you're failing and giving yourself permission to rest.

These are small changes. But they're the ones that actually make a difference.

When did you realise that the answer to more productivity was rest?