Sarah West I Certified ADHD Coach

A woman messaged me last week to ask if it was normal that her last ADHD coach spent most of each session telling her what to do.

This wasn't coaching. It was instruction dressed up as support, and she had paid for six weeks of it before she realised something was wrong.

ADHD coaching should be neuro-affirming. This means working alongside you as a thinking partner, helping you notice things for yourself and find what fits your own brain, rather than someone sitting across from you telling you what you should be doing.

ADHD coaching is currently unregulated. Anyone can call themselves a coach, set a price, and start taking clients tomorrow.

That means the responsibility for checking who you are working with sits, unfairly, with the person who is already exhausted and looking for help.

When coaching is done well, it can genuinely change someone's life for the better. When it is not, it can add to years of feeling criticised and misunderstood, which is the very thing most clients are trying to get away from.

Before you commit to working with anyone, it's worth asking:

-Where did they train, and how long was the course

-What does their ongoing professional development look like, and do they have continued professional development such as further courses, so they are practising at a high standard

A coach with nothing to hide will usually be glad to share this on their website.

Most decent ADHD coaches also offer a free discovery call, where you can talk about what you are struggling with and what kind of support you need.

Use it to notice how the conversation feels. Getting the right fit matters, and if you feel pressured to decide quickly, that is usually a sign to walk away.

I trained as a nurse long before I trained as a coach, and that background shaped how seriously I take questions of safety and standards.

Asking these questions is not awkward. It is exactly what a responsible coach expects and welcomes.

If you were choosing a coach today, what would matter most to you in that first conversation?

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.

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.

Our hormones are essential for how the brain makes and regulates dopamine.

When they fluctuate and drop during perimenopause, they affect 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, and we don't get the correct support.

This Wednesday 3rd June I'm presenting my monthly ADHD UK webinar on exactly this from 12 to 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.

A few weeks ago I wrote a Facebook post about perimenopause hitting my undiagnosed ADHD brain. About making plans to end my life.

Over 700,000 women saw it. Nearly 700 commented. 5,800 liked it.

And over 200 of you sent me direct messages telling me things you've never told anyone.

I've been reading them ever since. And I keep thinking: none of this should have happened to any of you.

Some of you wrote about reaching a point where you didn't want to be here anymore. Some wrote about the people you love who reached that same point.

Many wrote about the shame, the guilt, reaching out for help time and time again only to be dismissed and gaslit, given incorrect information or none at all.

Told they were the problem. Feeling they had nowhere left to turn.

Lifetimes of knowing that something about you was different but never having the right explanation for it.

I shared my story because I knew I wasn't the only one. Your messages have shown me just how true that is.

Thank you for sharing your stories with me. I'm sorry I can't reply to every one of you.

We have spent our lives feeling ashamed of things that were never our fault. Dismissed and misdiagnosed, told we were too much or that we were imagining it.

And we learned to say nothing and not trust that we could be vulnerable with others.

We are done with that. And this is exactly why I'm writing this book.

If you're in crisis or struggling with your mental health, trained support is available right now. Call Samaritans free on 116 123, day or night. Call 111 and select the mental health option. Or if calling feels tough, text SHOUT to 85258, any time.

Every message, every comment, every story shared.

Your voices deserve to be heard.

I walked out of my GP appointment feeling like the problem was me.

I knew what I wanted to say. I said it. But my GP didn't have the knowledge to do anything useful with it. They told me I couldn't have ADHD because I had a job and didn't look hyperactive. That I was too young for perimenopause and I'd need a blood test to confirm it.

Both of those things were wrong. And I had no way to show them that at the time.

That's the problem. We can walk into that appointment knowing exactly what's going on and still leave with nothing, because the person across from us doesn't recognise or understand what we're describing.

What we need is something tangible to take in with us.

Something that shows them clearly:

-Here are the signs and symptoms of ADHD in women.
-Here's how perimenopause presents.
-Here's how the two overlap. Look how many of these apply to me.

I hear this from women all the time. The same appointment. The same dismissal. The same walking out with nothing.

So I've got two free downloads for you, for exactly this reason:

-A symptoms checklist and diagnosis guide for ADHD, perimenopause and menopause

-A guide to understanding how your hormones are affecting your ADHD

Something you can print out, read through on your own, tick off what applies to you, and take in with you.

So the next time someone tells you that you don't look like you have ADHD, or that you're too young, you've got something in your hand that says otherwise.

Download both at the link in the comments.

Being dismissed by your GP isn't a sign you got it wrong. It's a sign they didn't know enough. Some doctors do get it. But far too many women are still leaving those appointments feeling like the problem is them.

What's the one symptom of your ADHD or perimenopause that you've found hardest to explain to your GP?

Some mornings I was too anxious to leave my house.

I was 48. A senior nurse in the NHS. Supporting and advocating for my neurodivergent children. Running a home. Caring for elderly relatives.

And I had no idea what was happening to me.

It was down to three hormones. And nobody had connected them to my ADHD.

ADHD already challenges how the brain regulates dopamine and serotonin. Perimenopause targets those same systems directly.

When both hit at the same time, the systems that allowed you to cope start to disappear.

Here's what each one does:

Oestrogen supports dopamine production. When it fluctuates and drops, focus and memory follow. What had felt manageable, suddenly doesn't.

Progesterone works on the receptors that calm the nervous system. When it falls, anxiety increases and sleep becomes more challenging than ever.

Testosterone drives motivation and makes executive function feel manageable. When it decreases, starting and finishing tasks gets harder.

But you tell yourself you're the problem.

You're not.

When all three decline together, the strategies you'd relied on for years stop working. Often ones you'd built without even realising that's what they were.

You weren't going crazy. You never were. Your neurochemistry was changing in ways nobody had explained to you.

Understanding this changes how you see yourself. Because from the moment you know, you can start accessing the right support.

Did you know these three hormones were connected to your ADHD?

A room full of women got answers they'd been waiting years for.

In an hour.

I recently spoke at a local women's support group on ADHD and the perimenopause. Most of them had already seen their GP. Most had been given antidepressants.

And how many had been told how significantly hormones affect ADHD?

None.

The women told me afterwards it was the first time they had truly felt seen and understood.

Educating others on how hormones and ADHD overlap is exactly what I do.

And right now, the women in your community, your waiting room, your retreat, or your team are looking to finally get the right answers.

-Registered nurse, 20 years in the NHS
-Trained ADHD coach and assessor
-One of ten UK Parliament ADHD advocates
-Presenting on ADHD and the perimenopause for ADHD UK every month
-Training GPs and clinical teams on how ADHD presents in women
-Every session grounded in current peer-reviewed research

I speak specifically on what happens when ADHD and perimenopause collide.

These two conditions interact in ways most healthcare professionals haven't been trained to recognise. And most of the women they're seeing have never been told the connection exists.

Women leave my sessions understanding:

-Why symptoms that felt manageable suddenly became impossible
-Why strategies that worked for years stopped
-Why and how hormones affect neurodivergent brains so significantly
-Why so many women are only now recognising they have ADHD
-Why they were told they were depressed or anxious when something else entirely was going on

For the first time, they know it was never personal failing.

For years these women have been misdiagnosed and dismissed.

They walk away with something they may never have been given before: an explanation for their own lives.

I have four speaking slots left for 2026. If your audience includes women navigating ADHD, perimenopause, or both, DM me with your event date and I'll tell you if it's a fit.

At 45 I was told by a GP that I was too young to be in the perimenopause.

Shame that GP wasn’t aware that women can be in the perimenopause in their 40’s, 30’s and a small percentage in their 20’s.

And women with ADHD?

They are likely to enter perimenopause up to ten years earlier than women without ADHD.

A 2023 population-based cohort study confirmed what so many of us have already lived: women with ADHD have a higher prevalence of severe perimenopausal symptoms, presenting at a much earlier age than the textbooks say they should.

Ten years earlier.

That's not a minor detail. That's a woman sitting in a GP's office at 45 being told she's too young, when the research says she's exactly on time.

I wasn't too young. The system was too slow.

So next time a GP tells you that you are too young to be in the perimenopause, remind them that the current UK NICE guidelines say to look at the symptoms in front of them, not just assign an arbitrary age and tell women what they are experiencing isn’t possible.

And an understanding of ADHD wouldn’t be bad either.

Research link in the comments.

Have you ever left a medical appointment knowing your doctor was wrong?

I was on a call with a woman I'd never met before. Within five minutes she was describing my life back to me.

The diagnosis that came too late. The perimenopause that hit before she had any framework for what was happening. The lists and routines that had held everything together for years, gone. And nowhere to turn that understood both. Every clinician she'd seen might know a bit about one side of it, but not the other. Most had told her it was anxiety.

She thought she was the only one. So did I.

When I started talking about it publicly, the messages came in within hours. Different names, different jobs, different cities, different lives.

Identical experience.

So I created this.

A structured group coaching programme for women with ADHD who are navigating perimenopause. Led by a nurse, a trained ADHD coach, and someone who has been exactly where you are.

From Tuesday 19th May. Eight spaces. Weekly 90-minute sessions on Google Meet, every Tuesday from 1pm to 2.30pm.

Each week I take the group through something different. Executive functioning. RSD. Emotional regulation. Time blindness. What your hormones are doing to your ADHD brain. What a late diagnosis means for your sense of self.

Practical tools that fit the way your brain works.

It's a rolling programme. No cohort that moves on without you. No end date.

A consistent weekly coaching space with women who get it without you having to explain it.

There's also a private WhatsApp community between sessions, and guest speakers including an advanced nurse practitioner specialising in menopause.

£150 a month. Eight spaces. There are a couple left.

The woman on that call isn't unusual. She's every woman who messages me.

She might be you.

If you're a woman with ADHD who's finding perimenopause is making everything harder to manage, the link in the comments takes you to the full programme details and how to sign up. Or drop me an email if you have any questions.

I checked my DMs this morning. Nine messages asking the same thing.

"Where do I train to become an ADHD coach?"

Twenty years as a nurse taught me one thing: if you're going to do this, you do it properly or you don't do it at all.

When I decided to train, I wasn't looking for a certificate I could get over a weekend.

I was looking for training I would be proud of, and that would give every client I worked with the standard of support they deserved.

That's how I found ADDCA (The ADD Coaching Academy). It's considered one of the gold standard training programmes for ADHD coaching in the world. Rigorously supervised and built around a depth of understanding that a short course cannot replicate.

It's a significant investment of your time and money. But the people sitting across from you are parting with their hard-earned cash, and they deserve proper support from someone who knows what they're doing.

You wouldn't work with a therapist who'd trained for a weekend.

You wouldn't see a physio who'd done a twelve-hour online course.

So why would you work with an ADHD coach who had?

Anyone I recommend reflects my professional standards. So I only point people toward programmes I'd stake my reputation on.

The ones I recommend:

-ADDCA: where I trained. ICF accredited. Foundation and Advanced levels.

-Kim Raine's Neurodiversity Training Academy: ICF accredited, Foundation and Advanced levels.

-Gold Mind Academy: ICF accredited, Certificate and Advanced pathways.

In every case, look for ICF accreditation, which shows that the programme has been properly assessed and that your hours count toward ongoing professional development.

ADHD coaching isn't regulated. There's nothing to stop someone completing an hour online and setting up as a coach tomorrow. No governing body. No minimum standard. Nothing.

There are short courses out there. Some are very cheap. Some can be completed in a number of weeks or less. They won't give you what you need to support an ADHD client properly. In some cases, they cause real harm.

So when someone asks me where to train, this is what I tell them:

Do it properly. The people you work with deserve nothing less.

When my ADHD was finally diagnosed, I thought the hard part was over.

Then perimenopause hit. The strategies I'd built stopped working. I didn't recognise myself. And there was nobody to ask. No one who understood both. No space to sit with other women going through the same thing and say, is this you too?

When I started talking about it more openly, I found I wasn't alone. The same story, from woman after woman. Months, sometimes years, of trying to make sense of why everything had got so much harder. No idea where to turn or what support even looked like for someone like them.

So I created it.

A structured group coaching programme, led by someone with the clinical knowledge and the lived experience.

From Tuesday 19th May, I'm opening a small group coaching programme for women with ADHD who are navigating perimenopause. Eight spaces. Weekly 90-minute sessions on Google Meet, every Tuesday from 1pm to 2.30pm.

Each week I take the group through something different. Executive functioning. RSD. Emotional regulation. Time blindness. What your hormones are doing to your ADHD brain. What a late diagnosis means for your sense of self. Practical tools that fit the way your brain works.

It's a rolling programme. No cohort that moves on without you. No end date. A consistent weekly space with women who genuinely get it.

There's also a private WhatsApp community between sessions, and guest speakers including an advanced nurse practitioner specialising in menopause.

£150 a month. Eight spaces, filled on a first come, first served basis. There are limited spaces left.

This is what I wish had existed when I needed it most.

If you're a woman with ADHD who's finding perimenopause is making everything harder to manage, the link in the comments takes you to the full programme details and how to sign up. Or drop me an email if you have any questions.