Sarah West I Certified ADHD Coach

Sarah West I Certified ADHD Coach Hi, I'm Sarah. I'm a nurse, ADHD assessor and certified ADHD coach specialising in supporting women who are late diagnosed ADHD and in perimenopause.

Over the years I’ve been given quite an impressive variation of anti anxiety and antidepressant medications. None of the...
08/09/2026

Over the years I’ve been given quite an impressive variation of anti anxiety and antidepressant medications. None of them ever really helped.

It felt like a revolving door. I’d sit opposite my GP and try to explain what was happening, exhausted all the time but somehow unable to sleep, my head full of a hundred different thoughts from the moment I woke up, always worrying and overthinking about everything.

I’d be told it was anxiety and depression and leave with yet another prescription.

The medication never really helped, and I didn’t know why.

I told myself it was my fault. That I was somehow failing, and that I was wasting everyone’s time. So I’d leave it for months, sometimes years, before going back and asking for help again.

Then perimenopause came along and turned the volume up on all of it. My anxiety increased, my confidence plummeted, my memory got worse, and my emotional regulation, my imposter syndrome, my rejection sensitivity, all felt magnified.

Hormones affect the brain, and research is increasingly showing that hormonal changes can influence ADHD symptoms in women, with oestrogen in particular playing an important role in the brain’s dopamine system, including dopamine production (Kooij et al., 2025).

Perimenopause can mean years of fluctuating and falling hormones. For women with ADHD, these hormonal changes can have a significant impact on the things that already take more effort, like focus, motivation, memory, organisation and getting things started or finished.

I thought I just needed to try harder. What I really needed was someone to understand the bigger picture.

If clinicians don’t understand how ADHD can present in women, or how hormonal changes can affect a neurodivergent brain, they may continue treating the symptoms they can see without recognising what else could be contributing to them.

How many women are repeatedly being treated for anxiety and depression, without anyone asking what else might be going on?

Reference in comments

I failed all my GCSEs at school. I went on to become a senior nurse. Then at 51, I started again.I’ve had quite a few ne...
01/09/2026

I failed all my GCSEs at school. I went on to become a senior nurse. Then at 51, I started again.

I’ve had quite a few new people follow me recently, so I thought it was probably time for a slightly awkward introduction.

I’m late diagnosed AuDHD, incredibly curious and apparently ask too many questions. I’ve never really understood why that’s a bad thing.

I’ve worked as a senior nurse in emergency surgery, intensive care and respiratory medicine, presented to GPs, appeared on podcasts and now deliver monthly webinars for ADHD UK on ADHD and perimenopause.

At 51, I gave up my NHS career and started my own business from scratch. Probably one of the scariest things I’ve done, but also one of the things I’m most proud of.

A huge part of what I do now is challenging clickbait and misinformation around ADHD and perimenopause. I care deeply about improving healthcare for people with ADHD, particularly when it comes to hormones, because we still have so much work to do.

Away from that, I cut the labels out of my clothes because the scratchiness drives me mad, wooden cutlery makes me feel sick and dresses without pockets are simply wrong.

I hate phone calls and would much rather send a voice note. I love chocolate, hate liquorice and I genuinely cannot sit through an entire film.

I studied photography at art school, I forget the rest of the world exists when I’m gardening and some of my best thinking happens while walking my two Golden Retrievers.

I grew up in North Cornwall, lived and worked in Oxfordshire for twenty years and now live in Devon. I also love wild swimming and have swum competitively in the sea along the North Cornwall coast and in the River Dart in South Devon.

Life has thrown some pretty big things at me too. I’ve had six rounds of IVF, I have two children who come before everything else and I had a severe eating disorder for 15 years from the age of 18.

I first called an ambulance when I was seven after my mum had an epileptic seizure while cooking chips (yes, those lovely 1970’s chip pans), and I’ve since had to perform CPR on two people in the street. I’m not entirely sure why emergency situations seem to keep finding me!

I buy cheap second hand phones because I drop and break far too many of them, I always read the personal information section of Wikipedia first and washing must be hung with tops by their bottoms and bottoms by their tops, or it makes my eye twitch.

I’ve never understood why people ask for your opinion if they don’t actually want an honest answer, so you’ll probably always get that from me too.

If you’ve been here for ages, thank you. If you’re new, hello 👋🏻

I’m really glad you’re here.

I used to get told off constantly at school for talking too much.Now I do it for a living.Caring for people has always b...
30/08/2026

I used to get told off constantly at school for talking too much.

Now I do it for a living.

Caring for people has always been hardwired into me. I’ve been a registered nurse for over 20 years, and now, as an ADHD coach, I combine my nursing background with my own lived experience to talk about how perimenopause and hormones can affect those with ADHD.

I’m late diagnosed AuDHD myself and mum to two AuDHD teenagers, so my work is informed by both my professional background and my own lived experience.

There’s a lot of misinformation out there, and not nearly enough reliable information reaching the people who need it. I always make sure the information I share is backed up by current, up-to-date evidence, because people deserve accurate information they can trust.

I want people to leave my talks with something they can actually use:

• A better understanding of ADHD and how hormonal changes during perimenopause can affect symptoms

• An explanation for symptoms they may have been struggling to make sense of

• More confidence to advocate for themselves, whether that’s with their GP, at work or at home

• A clearer idea of what support is available and where to go next

This week I’m bringing all of this together in a face to face talk at The Exeter Phoenix.

I’ll be talking about why ADHD can present differently in women and girls, and why so many first recognise it during perimenopause.

We’ll look at what we currently know about hormonal changes and ADHD, and why so many of us were told it was anxiety, stress or simply getting older.

There’ll be plenty of time for questions at the end.

There are just three tickets left.

📅 Thursday 3rd September
🕡 6.30pm to 8pm
📍 Exeter Phoenix
🔗 Link to book your space in the comments

What's the question about ADHD, perimenopause or hormones that you've never had the chance to ask?

For years, I thought I had bipolar disorder.What other explanation was there?I didn't know I had ADHD. Neither did anyon...
28/08/2026

For years, I thought I had bipolar disorder.

What other explanation was there?

I didn't know I had ADHD. Neither did anyone treating me.

My emotional regulation was all over the place, good for a stretch, then unable to cope, then back again, over and over. I felt like a complete freak who didn't fit in anywhere.

Every time I raised it, I was told it was anxiety. Or depression. New medication, more therapy, and still nothing changed.

Then perimenopause arrived, and it got even harder to ignore.

Nobody was looking for the pattern, because nobody knew what they were looking for.

It was like taking your car to the garage every month because the engine kept cutting out, and having someone replace the tyres, change the oil and check the brakes, without ever looking at the engine.

The problem wasn't that nothing was being done.

The problem was that nobody knew what the actual problem was.

I now know what was happening. ADHD, PMDD, RSD and hormones, all connected, and nobody, including me, ever knew to look for the pattern.

If you've been told it's anxiety, depression, or your hormones, and none of it has ever made sense, you are not imagining it.

How many of your own dots have never been joined up?

When perimenopause hit my ADHD brain, everything I'd always managed to keep together fell apart. I no longer recognised ...
27/08/2026

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 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 only a handful of spaces left.

Women shouldn't have to become experts in their own health just to be heard.This was one of the things I talked about in...
25/08/2026

Women shouldn't have to become experts in their own health just to be heard.

This was one of the things I talked about in my ADHD and perimenopause talk at Beautiful Days Festival last week, and it’s something I hear about frequently in my work.

Women regularly tell me what GPs have said to them:

“It’s anxiety.”

“That’s just your hormones.”

“You can’t have ADHD because you’ve held down a job.”

Nearly two thousand women have downloaded my free ADHD and perimenopause guides from my website, because they are struggling to find this information or need help understanding and explaining the difference to a healthcare professional.

I want to be very clear, I am most definitely not saying that healthcare professionals are rubbish.

There are many, many brilliant clinicians working incredibly hard to support women, and I know from my own experience in healthcare how stretched the system is.

But if clinicians haven't been given the training or information to understand both ADHD, perimenopause and how they can overlap, how can they be expected to recognise what's happening and effectively support the woman sitting in front of them?

Unfortunately, clinicians who understand both are still in the minority.

I don't blame individual healthcare professionals. The system hasn't given them the knowledge and training they need, but women are paying the price.

Women regularly tell me they haven't felt listened to, seen or understood, that their concerns have been dismissed, they've been given incorrect information, or had to research everything themselves before going to an appointment.

The consequences can be huge, affecting women's mental health, confidence, relationships, careers, physical health and quality of life.

Earlier recognition and understanding of ADHD and perimenopause could prevent so much of the unnecessary distress, disruption and impact on women’s lives.

We need a healthcare system that gives clinicians the knowledge and information they need, so women can get the right support without having to become their own specialists first.

Women deserve better. And this needs to change.

18/08/2026

It's easy to conclude that the problem is you.

That's how one woman described what it feels like when her ADHD medication stops working properly, and nobody can tell her why.

For years, women have told doctors, friends and each other that their hormones affect their ADHD symptoms and how well their medication works. Some days it barely touches the sides. Other days it works exactly as it should.

Until now, there has been almost no research into why.

Queen Mary University and King's College London have just launched a first of its kind study, tracking 50 women on ADHD medication through their menstrual cycles, alongside the impact on their daily lives.

One woman in the study, Kat Frize, said that like a lot of women, she assumed she just needed to try harder, be more organised or manage stress better. When you do not have an explanation, she said, it is easy to internalise the struggle and see it as a personal failing.

Shevonne Matheiken, Consultant Psychiatrists for Care ADHD explains in the article how oestrogen affects dopamine signalling in the brain, and dopamine plays a central role in attention, motivation and executive functioning. When oestrogen drops, whether that is during a cycle or during perimenopause, ADHD symptoms and medication response can change with it.

This is not a new theory, but it has taken decades for research to catch up with what women have been reporting all along.

For anyone who has ever wondered why some weeks feel manageable and others feel impossible for no obvious reason, it’s important to know that it is not a character flaw or inconsistent effort. It is biology that has not been properly studied until now.

What have you put down to "just needing to try harder" that might actually be your hormones having a big impact on ADHD?

Link to article in comments

I assumed my brain fog and tiredness was just ADHD and perimenopause. It wasn't the whole story. ADHD symptoms, perimeno...
17/08/2026

I assumed my brain fog and tiredness was just ADHD and perimenopause. It wasn't the whole story.

ADHD symptoms, perimenopause symptoms and some common deficiencies and medical conditions can overlap, and some of these can make ADHD symptoms feel significantly worse.

So, depending on your symptoms and medical history, it may be worth talking to your GP about checking things such as:

-FBC and ferritin. Particularly if you have heavy periods, as iron deficiency can contribute to fatigue, brain fog and poor concentration.

-Thyroid function. An underactive thyroid can cause fatigue, low mood, brain fog and problems with memory and concentration.

-B12 and folate. Deficiencies can contribute to fatigue and cognitive difficulties.

-Vitamin D. Where appropriate, as deficiency can contribute to fatigue and muscle weakness.

-HbA1c, to look at average blood glucose and your wider metabolic health.

And what about FSH (Follicle Stimulating Hormone) and oestradiol?

For most women aged 45 and over with typical perimenopause symptoms, NICE doesn't recommend routinely using hormone blood tests to diagnose perimenopause.

Hormone levels fluctuate considerably during perimenopause, so one blood test can give you a misleading snapshot.

This matters particularly when you have ADHD.

Changes in oestrogen can affect systems involving dopamine, which may contribute to changes in attention, motivation, working memory and executive functioning.

We shouldn't automatically assume every change is "just ADHD" or "just perimenopause".

Sometimes there could be something else contributing too.

The important thing is not to assume that every change is down to ADHD or perimenopause. There may be something else going on that is treatable and worth investigating.

If you're experiencing a significant change in your symptoms, it's best to speak to your GP or healthcare provider.

This is general information, not individual medical advice. The appropriate tests will depend on your symptoms and medical history.

Sources: NICE, Menopause: diagnosis and management, NG23; NICE, Attention deficit hyperactivity disorder: diagnosis and management, NG87.

When ADHD and perimenopause collided, everything I’d spent years learning to manage suddenly became harder.My anxiety an...
16/08/2026

When ADHD and perimenopause collided, everything I’d spent years learning to manage suddenly became harder.

My anxiety and imposter syndrome spiralled, my confidence disappeared, I stopped wanting to leave the house, and I no longer recognised myself.

And I had no idea why.

Was this ADHD? Was this perimenopause? Was it both?

Why had everything suddenly become so much harder?

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

That's exactly why I'm so pleased to be speaking at this face to face event at The Exeter Phoenix on Thursday 3rd September at 6.30pm.

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 join me, I'd love to see you there. It would be great to have you in the room for what I hope will be an honest and informative conversation about ADHD and perimenopause.

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.

Did you know that I also write blogs every month on different aspects of ADHD and perimenopause?There are now over 80 bl...
14/08/2026

Did you know that I also write blogs every month on different aspects of ADHD and perimenopause?

There are now over 80 blogs on my website, covering everything from ADHD and hormones to sleep, weight, emotional regulation and the many ways ADHD and perimenopause can overlap.

They’re all on my website.

Link in the comments.

You’re welcome.

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