ADHD in women over 40: perimenopause, late diagnosis, and treatment. Where do you even start?

Starting points for ADHD in women over 40 are usually an adult ADHD assessment plus whatever menopause or perimenopause care the symptoms already justify, not a single hormone treatment that treats both. Late adult diagnosis is commonly reported, and CADDRA notes that ADHD in women is often under-recognised and that comorbidities can mask or mimic ADHD. Perimenopause can make existing ADHD harder to manage; that is not proof that HRT treats ADHD. HRT may be considered for menopausal symptoms, but it is not a treatment for ADHD. Related reading: https://www.fastreat.com/HRT References: https://www.nice.org.uk/guidance/ng23 https://www.nice.org.uk/guidance/ng87/chapter/recommendations https://www.fastreat.com/HRT https://www.caddra.ca/wp-content/uploads/Practice-Summary-based-on-ADHD-and-Hormones-in-Women-with-Sara-Binder.pdf

I started at 44 by asking for an adult ADHD referral and a menopause symptom list on the same week, because I could not tell them apart. School comments helped more than any hormone story I had read. HRT came up for heat and sleep, not as an ADHD treatment, and I did not start it from a podcast. I am still waiting on parts of that path and still late to everything. My forties only.

Where I started was a GP who believed late diagnosis happens, plus a psychiatrist wait, plus a menopause leaflet that did not mention ADHD. I wanted one door. I got two. I did not use HRT to treat focus, and I did not use a stimulant to treat flushes. I still mix the symptoms up on bad days. This is my messy start, not a clinic map.