The tension a person can experience when bereaved by suicide is very real and can take up much internal space in the body and the mind. The mind can turn repeatedly towards the question of why, while the social world can feel altered and the body may experience all manner of challenges from sore shoulders and back pain to upset stomachs and tightness in the throat. The question of why is not one of curiosity as it quite often carries a sense of responsibility within it. People bereaved by suicide can experience this tiring question of ‘why’ alongside feelings of guilt, blame and anger. It is not unusual for people to replay conversations, to reconsider moments that once seemed ordinary and/or to search for something that might have been missed.

In 1969, Elisabeth Kübler-Ross, a Swiss-American psychiatrist, described grief as a process involving five stages, being denial, anger, bargaining, depression and acceptance, in her outstanding book ‘On Death and Dying’. In bereavement following suicide, these can appear in ways that feel somewhat chaotic and difficult to anticipate. Denial may take the form of a disbelief that the death has happened at all or a sense that it does not fit with what was known of the person who is no longer with us. Anger can emerge towards the person who has died, towards others or towards oneself, often intertwined with love and a resulting confusion. Bargaining may be felt in the repeated returning to moments that now carry new meaning alongside thoughts about what might have been different “if only”. Depression, in this context, speaks to the depth of the loss and the absence that follows, rather than our day -to-day understanding of depression. Acceptance is sometimes described as a form of coming to live with the reality of the death, even when it remains painful and incomplete. These stages are not linear or chronologically arranged. She later clarified that these stages were “never meant to help tuck messy emotions into neat packages” in her book ‘On Grief and Grieving’.

In suicide bereavement, this is particularly important. The processes she described do not unfold in order and, although this may be hard to read, they do not conclude. They move in and out of one another, sometimes within the same day or across days, months, years or lifetimes. I often think of any bereavement or loss as being similar to a knot in a beautiful piece of wood. The knot itself is forever there, tight, messy and not going anywhere. However, the beautiful piece of wood, which features the knot, is a result of growing around the knot over time. With the unique type of grief encountered when bereaved by suicide, it is not that the grief ever ends. It is that, as a person continues to experience their own living, they grow around the grief. It will always be painful; anytime you look at a picture or think about a time in the past, the grief can and often will come back, as if it was yesterday that the loss occurred. The ‘Five Stages of Grief’ framework can offer language for experiences that might otherwise feel disorganised but it does not set a path that must be followed.

What remains central is the relationship with the person who has died and the ongoing work of carrying that relationship in a life that has been altered. What does this mean? Well, if our grief was removed or done away with then it would be a dishonour to the person and the relationship we had with them. To feel the grief fully is to honour that person. To weep and feel physical pain at the thought of who that person was and could have been is a testament to the love held for them. It is unfortunate that due to the human condition we cannot experience that love without the potential to experience the grief of loss in some format.

In 1897, Émile Durkheim described suicide in terms of social forces suggesting that levels of connection and regulation within society are key. His work points towards the importance of belonging and social context, without locating responsibility in any one relationship. Edwin S. Shneidman, in his 1993 book ‘Suicide as Psychache’, wrote that “the common stimulus in suicide is unbearable psychological pain”, which he termed ‘psychache’. This idea can sometimes offer a way of understanding suicide as an attempt to escape suffering rather than as a rejection of others or a wish to die. In 2005, Thomas Joiner proposed that suicide emerges when a person experiences both a sense of not belonging and a belief that they are a burden. This is known as the interpersonal theory of suicide. It also suggests that suicidal behaviour is not simply a wish to die, but something that develops over time through exposure and habituation to pain or fear.

Similarly, in 2011, Rory O’Connor developed the Integrated Motivational Volitional model, which distinguishes between the emergence of suicidal thoughts and the transition to action. Within this model, feelings of defeat and entrapment, also interpreted as feeling powerless or helpless in one’s situation, can give rise to suicidal thinking, while factors such as access to means or impulsivity can influence whether a person acts on those thoughts. Again, these ideas do not explain a single death. They offer a language for thinking about how complex and layered these experiences can be.

Apart from theories that can help in understanding, there is often a felt difference in how this loss is held by others. Suicide bereavement is many times influenced by the social responses that follow. Research consistently identifies stigma as a central feature. This can show up in silence, in avoidance or in use of language as people may not know what to say or sometimes they say nothing at all.

If the person who died by suicide was young then there can be a sense that the life that was unfolding has been interrupted in a way that feels difficult to take in. Developmental expectations are disrupted and an imagined future becomes something else entirely, as the absence is not only of the person as they were but of who they were becoming.

There is also the presence of trauma within this kind of grief. Bereavement after suicide can involve intrusive thoughts, images or bodily responses that are not always associated with other forms of loss. The mind can return to the circumstances of the death in ways that feel involuntary which can make restorative rest difficult. It can make everyday life feel less predictable.

At the same time, it is important not to separate suicide bereavement too sharply from other forms of grief. There is a risk that in emphasising difference, the shared human aspects of mourning are lost. Certainly shame and self-blame can be present. However, grief remains grief and love remains present in the loss. Grief theorists have long tried to describe how people live with loss. Accepting the reality of the loss and processing the pain of grief can be the ultimate challenge and these tasks are not steps that are completed in order. They can be returned to repeatedly, especially when the death carries unanswered questions. Meaning making and honouring the person who died by suicide can be deeply challenging but ultimately supportive in living one’s own life. Talking about this and opening up to loved ones is the best way to go about it. Of course, Psychotherapy and Counselling is also an appropriate place to do this if doing it with loved ones feels too much to start with.

For more information on Leo’s services, 

phone: 085 1300573

email: info@leomuckley.com 

web: www.leomuckley.com 

sm: @leomuckleypsychotherapy

After many years of working with skin, I often find myself repeating the same advice to clients again and again, so this month I thought I’d share a few simple skincare reminders. Good skin is rarely about one miracle product; it’s usually about good habits and consistency. Cleansing properly, wearing SPF every day, protecting the skin barrier and sticking with a routine that suits your skin will always make more difference than constantly trying new products. I also often remind clients that while you can do a lot at home with good skincare, some concerns respond best when home care and professional treatments work together. Skincare shouldn’t stop at the face either – the neck, chest and body need care and sun protection too. Lastly, if your skin is angry and irritated, do less (stop over exfoliating!). Get the foundations right first, be consistent, and make sure what you’re using is actually right for your skin, that’s the real secret to healthy skin.

What’s hitting beauty shelves this month….

Dermalogica Pro-Collagen Banking Water Cream

New from Dermalogica this lightweight, intensely hydrating moisturiser is designed for dehydrated skin and early signs of ageing. It contains a peptide complex with collagen amino acids, zinc glycinate and carnosine, which help protect collagen and elastin from oxidative stress. It also includes red algae and white clover to help improve skin firmness and smoothness, along with hydrating ingredients to support the skin barrier and improve skin bounce and plumpness. The water-cream texture is very lightweight, making it a nice option for skin that needs hydration and barrier support without heaviness, €83, available from dermalogica.ie and Dermalogica stockists nationwide.

Eucerin Hyaluron-Filler Epigenetic Serum

Designed to target multiple signs of ageing such as fine lines, loss of elasticity and uneven skin texture, Eucerin Hyaluron-Filler Epigenetic Serum combines hyaluronic acid for hydration and plumping with epigenetic technology that helps support skin renewal and the skin’s natural repair processes. Hyaluronic acid helps attract and retain moisture in the skin, improving hydration and helping the skin appear smoother and plumper, while the epigenetic technology is designed to help reactivate youth-related skin functions at a cellular level, supporting skin regeneration and improving overall skin condition over time. The formula focuses on improving skin firmness, smoothness and elasticity rather than targeting just one concern, €56.99, available online from boots.ie and Eucerin stockists nationwide. 

Ella & Jo Nourishing Moment Shower Oil and The Glow Moment Body Oil

The latest additions to the Ella & Jo body care collection focus on cleansing, conditioning and supporting the skin barrier, leaving the skin soft and hydrated. The Nourishing Moment Shower Oil gently cleanses without stripping the skin and contains avocado, grapeseed and cranberry oils along with Vitamin E to help hydrate and condition the skin. The Glow Moment Body Oil is a lightweight, fast-absorbing oil rich in omegas and lipids that helps soften the skin, improve radiance and support the skin barrier. Both products have a lovely scent, fresh citrus with warm ginger and clove, finished with a soft woody note making them feel more like a treatment than just everyday body care, €28 and €35, available from ellaandjo.com and stockists nationwide.

Eleven Australia Miracle Hair Treatment

This all-in-one hair hero treatment from Eleven Australia is now available in a limited-edition bottle with 40% extra free. This lightweight leave-in treatment is suitable for all hair types and is designed to improve overall hair condition, shine and manageability. It hydrates and nourishes dry hair, helps control frizz and flyaways, detangles, and provides heat and UV protection, making it a very practical everyday product. It also helps strengthen the hair to reduce breakage, protect colour and keep hair smooth, soft and manageable without weighing it down, €24 available from elevenaustralia.ie and stockists nationwide.

To make an appointment for one of my Advanced Facial Treatments | Medical Microneedling | Byonik Laser | Dermalux LED Light Therapy |Slimyonik Body Airstyler | Teen Facials book online at www.shernamalone.ie 

Something has shifted in the way we talk about ageing, and it goes deeper than semantics. For a long time, the beauty and wellness industries operated on a single, largely unexamined assumption: that growing older was a problem requiring a solution. Treatments promised to “reverse”, “correct”, or “fight’”the signs of age, as though time itself were the enemy and the goal was always to wind the clock back. However, times are changing and there is a big shift in the aesthetic and wellness spaces.

Longevity medicine, once the preserve of Silicon Valley optimists and academic outliers, has become one of the fastest-growing areas of mainstream healthcare. Researchers are increasingly focused, not just on lifespan, but on healthspan: the quality and vitality of the years we live. Central to this is a growing understanding of the body’s regenerative capacity; its ability, given the right conditions, to repair, renew, and function at a high level well into later life. The skin, as the body’s largest organ, is no exception.

This science has fundamentally changed what good aesthetic medicine looks like. The most interesting practitioners today aren’t interested in making patients look younger. They’re aiming to make them look well.

The treatments gaining traction in clinics reflect this shift. Polynucleotides (purified DNA fragments originally developed in wound-healing medicine) have become one of the more talked-about developments in skin health in recent years. Rather than filling or freezing, they work at a cellular level, stimulating fibroblast activity and supporting the skin’s own repair mechanisms. The results tend to be subtle and cumulative: improved hydration, better texture, a quality of skin that reads as healthy rather than treated.

Microneedling operates on a related principle. By creating controlled micro-injuries in the skin, it triggers the body’s wound-healing response. This creates a controlled flood of collagen and elastin production that gradually improves firmness and resilience. It’s an intervention that works with the skin’s existing biology rather than overriding it.

More recently, exosome therapy has moved from research settings into clinical practice. Exosomes are essentially cellular messengers, carrying signalling proteins that instruct skin cells to repair and regenerate. Early clinical evidence is promising, and the approach fits neatly into a broader regenerative philosophy: less addition, more restoration.

Energy-based treatments have evolved along similar lines. IPL remains a reliable tool for addressing the cumulative effects of sun exposure — pigmentation, vascular changes, uneven tone — restoring a clarity that has more to do with health than youth. Erbium YAG laser resurfacing goes further, prompting significant collagen remodelling and skin renewal. Used thoughtfully, these technologies don’t alter the face so much as return it to a better version of itself.

Advanced skincare properly formulated, evidence-led products. rather than marketing-driven ones, underpins all of it. The barrier function, cellular turnover, and protection from environmental stressors determine the long-term health of the skin more than almost anything else.

What unites these approaches is a changed set of questions. Not “how do I look younger?” but “how do I look and feel my best?” Not “what can be corrected?” but “what does healthy skin actually need?” It’s a more honest conversation, and patients seem ready for it.

There’s also a growing recognition that the pursuit of a younger appearance has, in many cases, produced results that serve neither patient nor practitioner well. Overcorrection, homogenisation, the uncanny valley of faces that have clearly been worked on. These are the visible failures of an industry that prioritised a single aesthetic ideal over individual health and character.

The pro-ageing movement isn’t anti-intervention. It’s anti-erasure. The distinction matters. A person in their fifties who looks vital, rested, and healthy has aged well, regardless of whether they’ve had help getting there. The goal is function and vitality, not the simulation of a different decade or different person altogether.

Mainstream medicine is beginning to reflect this too. Preventive and regenerative approaches, from NAD+ protocols and peptide therapies to mitochondrial health and microbiome research, are entering clinical conversations that would have seemed fringe just a decade ago. The picture emerging is one in which ageing is not reversed but optimised: a process managed with intelligence and care, rather than one fought and resented.

Aesthetics, at its best, is part of that broader project. Skin health is health. Looking well is, more often than not, a reflection of being well. And the treatments and technologies now available make it increasingly possible to support both, not by chasing youth, but by investing in the conditions that allow people to age with vitality, confidence, and genuine wellbeing. I feel genuinely excited to see where this movement takes us.

“Conformity is the only real fashion crime. To not dress like yourself and to sublimate your spirit to some kind of group identity is succumbing to fashion fascism.” Simon Doonan

Ageing is an inevitable part of life but how we approach it can transform the entire experience. Once upon a time growing older was embraced and people assumed the glorified position of ‘wise elders’ in the community.

Experience, hardships, laughter and love etched into the face, hands and fingernails showed the signs of hard work. There seemed to be an acceptance and even welcome to slowing down.Times were different then and today’s society is much more concerned with the slow down of ageing. I definitely feel that the emphasis on looking after your body as you age is becoming more and more important – moving more and, most importantly, challenging your brain, as you get older. I always loved to study and I’m studying again now at an age where focus and retention may have completely left the building, haha! Persistence, repetition and patience – these have become my mantra because they work. Research has shown that it is the 50-, 60- and 70-year-olds who need more intellectual stimulation than a younger brain. In the same way that you practise speaking a new language, when you stop, the parts of the brain that had been stimulated to retain that learned language die. Slipping into a daily non-challenging routine is detrimental to the brain and the body and expedites ageing.The exact same is true when it comes to moving the body and exercising. Emotional resilience also needs tending to, so that you can cope with life on life’s terms!

Our bodies change and, as we mature, many of us can get stuck in a rut and just stay comfortable when it comes to fashion. Ageing gracefully doesn’t mean pretending to be young, what it does mean is that you make peace with the ageing process while staying stylish and doing what you can (safely) to look your best. I’m not going to rant and rave about skincare procedures that are poisoning the body in order to look young – do your own research, of which there is limited longterm! Also, a wonderful college professor once told us that when you look at who funds safety studies, you need to sift through to find studies that are NOT funded by the product/procedure in question – in other words, the results may be compromised. Mindset is huge when it comes to ageing, it is so important to try to adapt a lighthearted approach and not obsess about it because if you allow yourself to get stressed, then you will flood your body with cortisol and look older. I don’t use anti-ageing creams – companies send them to me but, other than a Vitamin C cream that RSVP sent to me last year, I don’t use them at all. I eat well, use old remedies and drink Nettle tea to purify my blood. I have found my passion in life and embrace it, I garden without gloves (Google the benefits of doing that), I take a high dose of CoQ10 and I laugh at myself ‘all’ the time. I use Nivea body cream on my face and mix a little BioOil into it, every so often I use local honey as a mask and I’m of the mind that perhaps there are anti-ageing benefits to dogs licking your face!

Your wardrobe can and will dramatically influence how you feel as you age. You need to honestly ask yourself if you are still wearing a much-loved style from 15 or 20 years ago – a classic tailored cut is exempt from this. The longer you live, the more experiences that you go through and inevitably, these experiences will change you, so you need to ask yourself if your clothes reflect who you are today. Dressing for who you are now rather than who you used to be boosts confidence and is enormously liberating. Social media is a wonderful and useful tool when used carefully for advice and ideas when it comes to what to wear as you age. What you need to be careful of is who you follow for tips and how much is real or artificial. Most influencers use airbrushing apps, use products and treatments that are beyond our budgets and are well-informed on camera angles and so on.Reinventing your wardrobe is something that you have to do regularly as you age. Holding onto clothes that you haven’t worn in a long time creates a stagnant wardrobe and stops you from moving on. There will always be some items that will only be worn on rare occasions, like funeral attire, ball gowns and event style. These pieces, once they still fit comfortably, can occupy a section of your wardrobe, but jeans that you put on and take off and never wear, need to be given away, passed on to a friend or sold on an app like Vinted or Depop. Simplicity is key. Blazers, dressy blouses, kimono-style light long cardigans can change an everyday pair of jeans to a ‘going out’ look. The quickest way to revive your wardrobe is by experimenting with unexpected pairings. What about trying that silk blouse – usually reserved for a very formal event – with a pair of denim jeans and trainers? This is a great day-into-evening look, sophisticated yet effortless on a more mature body.

The colour and shape of clothes is a power tool as you age. We all know the colours that shine on us but, as we age, the shade might need to change somewhat. We change our make-up shade and texture, as our skin ages; our hair colour, as more greys appear, so it only makes sense that the colours of our clothes would change too. Have you ever put on an outfit that you used to love, only to feel like something is off? Maybe your features seem less defined, your skin looks a little tired or the colour just doesn’t ‘pop’ like it used to. Colours that once flattered you may now dull your natural glow instead of enhancing it. What you need to do is to stand in daylight with a mirror, put a colour near your face and you will see if it reflects light onto your face to make you ‘glow’. Another colour will absorb the light, which will make you look tired or washed-out. Black is a classic colour that will hide a multitude but, for some people, it can emphasise shadows and fine lines. Opt for a deep espresso or soft charcoal instead. Soft pale yellow may sound like a cheerful colour but it washes out most Irish people, as it lacks contrast and is too close to our natural skin undertone. Opt for a warm amber or golden yellow instead. Stark white can be surprisingly unflattering on many Irish women, as it is too bright and harsh and highlights an uneven skin tone. Opt for cream or ivory instead. Baby blues, lavenders or pale pink are shades that can sometimes feel ‘flat’. They lack warmth and can make the skin look less vibrant. Opt for coral, peach or warm rose instead. Deep navy and teal, burgundy and plum, warm greens, peach and coral and soft rose and blush can all work wonders on ageing skin. Wear brighter colours near your face or use layering by adding a softer tone between your face and darker pieces.

Accessories can be absolute game-changers! A belt can transform the feel of a familiar outfit and as we age, the thickness and position of a belt will need to change, perhaps to accentuate a curve where a waist is disappearing.

Shop intentionally. Always ask yourself if a new addition will pair with at least three of your existing items. This will stop the urge to impulse buy. There is no set guideline as to what you should wear when you are 40, 50, 60 or 70. What is imperative is that you have good-fitting enhancing underwear, which is always worth the extra cost. Don’t allow yourself to get into the habit of wearing the same clothes style everyday. The days that you are struggling with confidence and energy are the days that you should wear the brightest of colours, the best jeans or a piece that you get loads of compliments every time you wear it. Gone are the days where you save something good for an occasion, every day is an occasion, wear it now.

“It is a privilege to age….” Phrases like these may make you want to scream. It is not easy being positive about ageing in the face of all that modern society hurls at us over-50s when everything about ageing for women is negative: We are not fertile, not deemed attractive and the physical changes of ageing, such as wrinkles, are deemed ugly, to be erased with serums, injections, or the knife. But the same criticism is not wielded at men; if they have grey hair they are a ‘Silver Fox’ – their wrinkles looked on as distinguished not ugly features.

What we should be asking is Why? Why do women, especially in West Cork, live to such an old age? What is our purpose?

We seem to have an evolutionary mystery here: Why do we live so long beyond the age when we can reproduce? Classic Darwinian theory would predict otherwise, as natural selection favours mutations that increase reproduction and tends to put a cap on survival after reproduction ceases. In fact, almost all female mammals from elephants to squirrels, badgers and meerkats, live only for relatively short periods of time after reproduction ceases.

For human females, a third of our lives will be lived after menopause and only a  handful of mammals do this; orcas, beluga, narwhal and short-fined pilot whales and, according to a recent study, chimpanzees from one population in western Uganda.

The evolutionary purpose of women living 20 or 30 years post reproductive age is that we bring intrinsic value to our society, and I am not talking about being a babysitter on tap for grand kids. I mean sharing our skills, nurturing and teaching others. All of our gleaned wisdoms and skills have value: be it music, art or poetry; it could be crochet or baking, organising and decluttering. Me? I started to write for West Cork People in 2023. I like sharing my knowledge and hope it helps women. As we age, we learn patience, tolerance, acceptance and therefore become better listeners,  better friends and partners.

I say embrace being part of the matriarchy and, dare I say it, embrace your inner crone!

I went to visit my Auntie Breda, age 98, today and wanted to share her insight. She was born, raised, married, had seven children and lived all her life in  the small village of Whitegate in East Cork. She currently is living in Youghal community nursing home. Physically frail but still mentally sharp as a tack, we talked about what it meant to age,  to get old. We talked about dying and we decided we are all dying, because in the end, we all will die – but that is not the point of life.

She felt the important thing is that we enjoy life and I am happy to share my East Cork matriarch’s advice here, salty language and all:  just don’t give a  f#ck what others say or think about you; stop trying to change; just be you.

Women’s physical health:
the facts

• One in two women over the age of 50 will suffer an osteoporotic fracture.

• One in three women, age 75 will die of a heart attack or stroke.

• One in two women over 60 years have high blood pressure and most are unaware. High blood pressure is the lead cause of heart attack and stroke in women if left untreated. The harsh reality with high blood pressure is that you get no symptoms; you feel absolutely fine until you have that stroke or heart attack.

• Women’s cholesterol changes through menopause transition, with total, as well as the bad LDL cholesterol, going up. High LDL is thought to be the strongest predictor of heart disease in women.

• A high BMI, over 30, increases a woman’s risk of heart attack threefold. 

Menopause transition results in weight gain, on average 7kg according to studies, but in reality it is more. That weight sits around the belly, known as central obesity and is incredibly difficult to shift. The combination of central obesity and lipid changes is called metabolic syndrome and is associated with  higher risk of developing diabetes.

Women over 60 increasingly experience urinary symptoms of frequency, passing urine many times in the day, nocturia; getting up at night to pee, discomfort when you wee like a cystitis feeling and recurrent urinary tract infections (UTIs) are common in the over-70s. Incontinence is sometimes thought to be the inevitable companion of ageing and we will all end up in pads by the age of 80. Not true: UTIs and incontinence in our old age are preventable!  

While the medical conditions mentioned above are related to falling oestrogen levels through menopause, they are not inevitable. So what can we do to stay healthy into our 80s? Well, prevention is better than cure!

Cardiovascular disease
(CVD)  prevention

Hypertension or high blood pressure, diabetes and heart disease are prevalent in women over 60. Diabetes, heart disease and stroke, however, are all preventable.

Regular aerobic exercise, a healthy low fat, Mediterranean diet, not smoking,  moderate drinking, weight loss, keeping BMI under 30 will all result in a massive reduction in your risk of having a heart attack or stroke or becoming diabetic.

See your GP once a year for blood pressure, cholesterol and HbA1C. The HbA1C test picks up pre-diabetes. If diabetes is caught at this stage and you make changes to diet, increase exercise even if you don’t loose weight, you will stop yourself becoming diabetic. Once diabetes is diagnosed you have a one in three risk of heart attack or stroke in the next 10 years so you want to catch that bugger early. 

If you are found to have even slightly raised blood pressure, you take a once a day tablet. If your pressure is kept low, the high blood pressure effects on the heart, kidney and brain simply does not happen and you prevent your heart attack, heart failure, atrial fibrillation, stroke and kidney failure.  

If cholesterol and LDL are raised, a once a day statin tablet has been shown in studies to result in a 50 per cent reduction in your risk of heart attack or stroke over the next 10 years. Even if your cholesterol is not raised, this benefit is seen.

The female heart

Most studies looking at heart disease or trials developing cardiac drugs have been done using male participants. Female coronary heart disease (CHD) is different to male; we tend to have issues with our small coronary arteries; men tend to block off their big arteries. Symptoms can be completely different between the sexes.

Women tend not to get classic chest pain when exercising that men present with; there can be pervasive fatigue; you might feel breathless or lightheaded when you exercise or just feel you don’t have the energy to get out for a walk. Symptoms can be triggered by worry or stress rather than exercise,  so can be put down to psychological chest pains rather than cardiac symptoms resulting in delayed diagnosis. 

Don’t ignore symptoms,  see your GP: if you are diagnosed with CHD before you have that heart attack you prevent damage to a section of heart muscle. This part will  not move properly after a heart attack resulting in a weak heart pump, a condition called heart failure. Yes, once diagnosed with CHD, you need to take a few tablets every day but surely that is better than being dead or very breathless and unable to exercise or walk.

Osteoporosis and falls prevention: calcium and vitamin D, exercise and weight training

We need a minimum 1000 units Vit D per day and this is impossible to get in our food plus we live in the wrong country; 80 per cent of people in Ireland are vitamin D deficient because of lack of sunshine.

We need 1200mg calcium per day. Use this calculator (www.osteoporosis.foundation/educational-hub/topic/calcium-calculator) to work out if you are eating enough and if not your GP can prescribe a combination calcium plus Vitamin D tablet.

Walking helps muscle and bone strength and West Cork women are big walkers. But weight training is also really important. I am not talking about massive dumbbells and hours in the gym; most gyms throughout West Cork are running women-only weight training sessions. A session involves using very low weights in a repetitive way, 10 to 20 movements in each set, to build up different muscle groups. This results in better core strength and balance, prevents falls and will increase your bone density.  

Studies have shown that you get benefits from what they call exercise snacking; just doing a 10 to 15 minute session several times per week. Once you know what exercises to do, get yourself a set of weights and you can do them at home. 

Oestrogen therapy for the over 70s

Vaginal oestrogen is safe and, in my opinion, essential for all women over 60. Systemic HRT,  not so much. 

Systemic HRT means using oestrogen as a tablet or through the skin as patch, gel or spray, which is absorbed into your bloodstream and acts all around the body.

Evidence from recent studies and Cochrane analysis suggests that systemic HRT started under the age of 60 or within 10 years of the last menstrual period is associated with a reduction in atherosclerosis progression, coronary heart disease, CHD,  and death from all cardiovascular causes as well as all cause mortality. More recent evidence points to greater CVD benefits by starting within six years of last period.  

Four to five years systemic HRT use is associated with almost halving of risk of osteoporotic hip fracture by the age of 65. 

However, studies have repeatedly failed to show any benefit for CVD or osteoporosis prevention when systemic HRT is started for the first time in women over the age of 60. There is also some evidence that doing so might lead to slightly increased risks of heart attack or stroke.  Studies showing that, however, did include women aged 69 to 75, who inherently have a higher risk of CVD.

In short, as a menopause doctor, do I ever start systemic HRT for the first time in a woman over 70?  No, because of the lack of evidence for benefit.

However, if a 70-year-old patient already using systemic HRT for many years wants to continue, that is a different situation. The issue here is that prolonged HRT use for greater than five to 10 years,  is linked with slightly increased risk of breast cancer. 

Genitourinary Syndrome of Menopause (GSM) 

GSM is the term used to describe the effects that oestrogen deficiency has on three areas: genital skin, the vagina and the urinary tract.

Local oestrogen therapy is not just about sexy time; many women assume because they are not sexually active, or they are, but do not experience discomfort, that there is no need to use vaginal oestrogen. Not true!

The urinary symptoms so common in women over 70 are caused by oestrogen deficiency. Using vaginal oestrogen will usually completely cure the symptoms.

Local oestrogen therapy can be a cream or pessary. Cream can be applied to skin of external genital area and also inserted inside the vagina with an applicator. Cream is preferable if there is any soreness burning, itching of skin of genital area.

Think of it like filling an empty tank; if you are 70, your bits have not had any oestrogen for 20-plus years; you will need to use it daily for four weeks, then two to three times per week.

Skin symptoms usually resolve quickly in a week or two. For urinary symptoms of dashing to the loo, leaking if you cannot get there fast enough, getting up at night to pee, leaking when you sneeze and discomfort when peeing and UTIs, it tends to take longer before you see a benefit; sometimes a few months,  so stick with it.

Studies have shown that long term use of vaginal oestrogen is associated with reduced risk of incontinence and recurrent UTIs in our old age.

Is local oestrogen therapy safe? Yes, even if you have had breast cancer in the past.

Studies looking at vaginal oestrogen use in women with a history of breast cancer have not shown any increase in cancer recurrence or in mortality.

Studies of women using vaginal oestrogen long term have showed it is not significantly absorbed as their blood oestrogen levels remain very low.

You will find more information on GSM in the British Menopause Society Women’s Health information leaflet accessible on www.thebms.org.uk.

If you have symptoms suggestive of GSM, please see your GP. If needed, your GP can refer you to be seen at the gynaecology clinic in Bantry.“I

t is a privilege to age….” Phrases like these may make you want to scream. It is not easy being positive about ageing in the face of all that modern society hurls at us over-50s when everything about ageing for women is negative: We are not fertile, not deemed attractive and the physical changes of ageing, such as wrinkles, are deemed ugly, to be erased with serums, injections, or the knife. But the same criticism is not wielded at men; if they have grey hair they are a ‘Silver Fox’ – their wrinkles looked on as distinguished not ugly features.

What we should be asking is Why? Why do women, especially in West Cork, live to such an old age? What is our purpose?

We seem to have an evolutionary mystery here: Why do we live so long beyond the age when we can reproduce? Classic Darwinian theory would predict otherwise, as natural selection favours mutations that increase reproduction and tends to put a cap on survival after reproduction ceases. In fact, almost all female mammals from elephants to squirrels, badgers and meerkats, live only for relatively short periods of time after reproduction ceases.

For human females, a third of our lives will be lived after menopause and only a  handful of mammals do this; orcas, beluga, narwhal and short-fined pilot whales and, according to a recent study, chimpanzees from one population in western Uganda.

The evolutionary purpose of women living 20 or 30 years post reproductive age is that we bring intrinsic value to our society, and I am not talking about being a babysitter on tap for grand kids. I mean sharing our skills, nurturing and teaching others. All of our gleaned wisdoms and skills have value: be it music, art or poetry; it could be crochet or baking, organising and decluttering. Me? I started to write for West Cork People in 2023. I like sharing my knowledge and hope it helps women. As we age, we learn patience, tolerance, acceptance and therefore become better listeners,  better friends and partners.

I say embrace being part of the matriarchy and, dare I say it, embrace your inner crone!

I went to visit my Auntie Breda, age 98, today and wanted to share her insight. She was born, raised, married, had seven children and lived all her life in  the small village of Whitegate in East Cork. She currently is living in Youghal community nursing home. Physically frail but still mentally sharp as a tack, we talked about what it meant to age,  to get old. We talked about dying and we decided we are all dying, because in the end, we all will die – but that is not the point of life.

She felt the important thing is that we enjoy life and I am happy to share my East Cork matriarch’s advice here, salty language and all:  just don’t give a  f#ck what others say or think about you; stop trying to change; just be you.

Women’s physical health:
the facts

• One in two women over the age of 50 will suffer an osteoporotic fracture.

• One in three women, age 75 will die of a heart attack or stroke.

• One in two women over 60 years have high blood pressure and most are unaware. High blood pressure is the lead cause of heart attack and stroke in women if left untreated. The harsh reality with high blood pressure is that you get no symptoms; you feel absolutely fine until you have that stroke or heart attack.

• Women’s cholesterol changes through menopause transition, with total, as well as the bad LDL cholesterol, going up. High LDL is thought to be the strongest predictor of heart disease in women.

• A high BMI, over 30, increases a woman’s risk of heart attack threefold. 

Menopause transition results in weight gain, on average 7kg according to studies, but in reality it is more. That weight sits around the belly, known as central obesity and is incredibly difficult to shift. The combination of central obesity and lipid changes is called metabolic syndrome and is associated with  higher risk of developing diabetes.

Women over 60 increasingly experience urinary symptoms of frequency, passing urine many times in the day, nocturia; getting up at night to pee, discomfort when you wee like a cystitis feeling and recurrent urinary tract infections (UTIs) are common in the over-70s. Incontinence is sometimes thought to be the inevitable companion of ageing and we will all end up in pads by the age of 80. Not true: UTIs and incontinence in our old age are preventable!  

While the medical conditions mentioned above are related to falling oestrogen levels through menopause, they are not inevitable. So what can we do to stay healthy into our 80s? Well, prevention is better than cure!

Cardiovascular disease
(CVD)  prevention

Hypertension or high blood pressure, diabetes and heart disease are prevalent in women over 60. Diabetes, heart disease and stroke, however, are all preventable.

Regular aerobic exercise, a healthy low fat, Mediterranean diet, not smoking,  moderate drinking, weight loss, keeping BMI under 30 will all result in a massive reduction in your risk of having a heart attack or stroke or becoming diabetic.

See your GP once a year for blood pressure, cholesterol and HbA1C. The HbA1C test picks up pre-diabetes. If diabetes is caught at this stage and you make changes to diet, increase exercise even if you don’t loose weight, you will stop yourself becoming diabetic. Once diabetes is diagnosed you have a one in three risk of heart attack or stroke in the next 10 years so you want to catch that bugger early. 

If you are found to have even slightly raised blood pressure, you take a once a day tablet. If your pressure is kept low, the high blood pressure effects on the heart, kidney and brain simply does not happen and you prevent your heart attack, heart failure, atrial fibrillation, stroke and kidney failure.  

If cholesterol and LDL are raised, a once a day statin tablet has been shown in studies to result in a 50 per cent reduction in your risk of heart attack or stroke over the next 10 years. Even if your cholesterol is not raised, this benefit is seen.

The female heart

Most studies looking at heart disease or trials developing cardiac drugs have been done using male participants. Female coronary heart disease (CHD) is different to male; we tend to have issues with our small coronary arteries; men tend to block off their big arteries. Symptoms can be completely different between the sexes.

Women tend not to get classic chest pain when exercising that men present with; there can be pervasive fatigue; you might feel breathless or lightheaded when you exercise or just feel you don’t have the energy to get out for a walk. Symptoms can be triggered by worry or stress rather than exercise,  so can be put down to psychological chest pains rather than cardiac symptoms resulting in delayed diagnosis. 

Don’t ignore symptoms,  see your GP: if you are diagnosed with CHD before you have that heart attack you prevent damage to a section of heart muscle. This part will  not move properly after a heart attack resulting in a weak heart pump, a condition called heart failure. Yes, once diagnosed with CHD, you need to take a few tablets every day but surely that is better than being dead or very breathless and unable to exercise or walk.

Osteoporosis and falls prevention: calcium and vitamin D, exercise and weight training

We need a minimum 1000 units Vit D per day and this is impossible to get in our food plus we live in the wrong country; 80 per cent of people in Ireland are vitamin D deficient because of lack of sunshine.

We need 1200mg calcium per day. Use this calculator (www.osteoporosis.foundation/educational-hub/topic/calcium-calculator) to work out if you are eating enough and if not your GP can prescribe a combination calcium plus Vitamin D tablet.

Walking helps muscle and bone strength and West Cork women are big walkers. But weight training is also really important. I am not talking about massive dumbbells and hours in the gym; most gyms throughout West Cork are running women-only weight training sessions. A session involves using very low weights in a repetitive way, 10 to 20 movements in each set, to build up different muscle groups. This results in better core strength and balance, prevents falls and will increase your bone density.  

Studies have shown that you get benefits from what they call exercise snacking; just doing a 10 to 15 minute session several times per week. Once you know what exercises to do, get yourself a set of weights and you can do them at home. 

Oestrogen therapy for the over 70s

Vaginal oestrogen is safe and, in my opinion, essential for all women over 60. Systemic HRT,  not so much. 

Systemic HRT means using oestrogen as a tablet or through the skin as patch, gel or spray, which is absorbed into your bloodstream and acts all around the body.

Evidence from recent studies and Cochrane analysis suggests that systemic HRT started under the age of 60 or within 10 years of the last menstrual period is associated with a reduction in atherosclerosis progression, coronary heart disease, CHD,  and death from all cardiovascular causes as well as all cause mortality. More recent evidence points to greater CVD benefits by starting within six years of last period.  

Four to five years systemic HRT use is associated with almost halving of risk of osteoporotic hip fracture by the age of 65. 

However, studies have repeatedly failed to show any benefit for CVD or osteoporosis prevention when systemic HRT is started for the first time in women over the age of 60. There is also some evidence that doing so might lead to slightly increased risks of heart attack or stroke.  Studies showing that, however, did include women aged 69 to 75, who inherently have a higher risk of CVD.

In short, as a menopause doctor, do I ever start systemic HRT for the first time in a woman over 70?  No, because of the lack of evidence for benefit.

However, if a 70-year-old patient already using systemic HRT for many years wants to continue, that is a different situation. The issue here is that prolonged HRT use for greater than five to 10 years,  is linked with slightly increased risk of breast cancer. 

Genitourinary Syndrome of Menopause (GSM) 

GSM is the term used to describe the effects that oestrogen deficiency has on three areas: genital skin, the vagina and the urinary tract.

Local oestrogen therapy is not just about sexy time; many women assume because they are not sexually active, or they are, but do not experience discomfort, that there is no need to use vaginal oestrogen. Not true!

The urinary symptoms so common in women over 70 are caused by oestrogen deficiency. Using vaginal oestrogen will usually completely cure the symptoms.

Local oestrogen therapy can be a cream or pessary. Cream can be applied to skin of external genital area and also inserted inside the vagina with an applicator. Cream is preferable if there is any soreness burning, itching of skin of genital area.

Think of it like filling an empty tank; if you are 70, your bits have not had any oestrogen for 20-plus years; you will need to use it daily for four weeks, then two to three times per week.

Skin symptoms usually resolve quickly in a week or two. For urinary symptoms of dashing to the loo, leaking if you cannot get there fast enough, getting up at night to pee, leaking when you sneeze and discomfort when peeing and UTIs, it tends to take longer before you see a benefit; sometimes a few months,  so stick with it.

Studies have shown that long term use of vaginal oestrogen is associated with reduced risk of incontinence and recurrent UTIs in our old age.

Is local oestrogen therapy safe? Yes, even if you have had breast cancer in the past.

Studies looking at vaginal oestrogen use in women with a history of breast cancer have not shown any increase in cancer recurrence or in mortality.

Studies of women using vaginal oestrogen long term have showed it is not significantly absorbed as their blood oestrogen levels remain very low.

You will find more information on GSM in the British Menopause Society Women’s Health information leaflet accessible on www.thebms.org.uk.

If you have symptoms suggestive of GSM, please see your GP. If needed, your GP can refer you to be seen at the gynaecology clinic in Bantry.

Patrick has spent over 20 years working in this area through the Food for the Brain Foundation, an online Charity that has now assessed the cognitive health of nearly half a million people. What’s emerging from that work is quite striking: the story we are being told about dementia may be missing the bigger picture.

Rather than focusing solely on amyloid plaques, Patrick argues that factors like high homocysteine levels, poor blood sugar control, and lifestyle habits are far more powerful predictors of brain decline. He also asserts that dementia should not be viewed as an unavoidable consequence of getting older, but rather as a preventable disease in many instances. 

In fact, he suggests that up to 73 per cent of cases could be avoided by modifying our diets and lifestyles. 

That’s a hopeful message. If you want to read more, there’s SO much information on foodforthebrain.org – but here’s some things you can add into your diet this week to start making a difference. 

Feed your brain with
omega-3 fats

The message is simple: our brains are built from fat – around 60 per cent of it. But not just any fat, but specifically omega-3 fatty acids like DHA.

This is where traditional diets come in. Patrick spoke about how our ancestors evolved along coastlines, eating seafood – mussels, seaweed, small fish like sardines and mackerel – which helped grow the large, complex brains we have today. Yet many of us now eat little to no fish.

The shift is simple: aim for two to three servings of oily fish a week – sardines, mackerel, herring. Tinned is perfectly fine, but look for Irish brands that fish as sustainably as possible like Shines Seafood. 

If that’s not realistic, a good-quality omega-3 supplement (rich in DHA) is one of the most important additions you can make. Also, walnuts, flax, chia seeds and leafy greens can also help support your omega 3 levels. 

Lower homocysteine
with B vitamins

If there was one concept that really landed during Patrick’s talk, it was homocysteine. Patrick describes it as a “toxic amino acid” that damages both brain cells and arteries. When levels rise, memory tends to decline – and when levels fall, memory improves.

The key to keeping it in check? B vitamins – particularly B6, B12 and folate. These are found in leafy greens, whole foods, and also in good-quality B-complex supplements. But here’s the important bit: B vitamins don’t work properly without adequate levels of omega-3 – so the two go hand in hand.

If you would like to test your Homocysteine levels, you can order the home blood test kit from foodforthebrain.org. This can help you to know if you need to add in more B Vitamins. 

Balance your blood sugar

Another strong theme from Patrick’s talk was blood sugar.

“Sugar kills brain cells,” he said bluntly – and while that may sound dramatic, the connection between high blood glucose and cognitive decline is increasingly well-established.

A diet high in refined carbohydrates and sugar can push us towards insulin resistance and pre-diabetes – both of which are strongly linked to dementia risk.

The goal isn’t perfection, but stability: Cut back on sugar and ultra-processed carbs; include protein and healthy fats with all meals; and eat your veg first – this slows down glucose absorption.

Eat colour, plants and protective compounds

Beyond fats and balanced blood sugar levels, our brains thrive on antioxidants and plant compounds.

Berries – especially blueberries – are rich in anthocyanins, which can cross the blood-brain barrier and help protect brain cells from ageing and damage. Leafy greens bring folate and vitamin C, while foods like dark chocolate, green tea and turmeric add further protective benefits.

Curcumin (from turmeric), for example, has been shown to support levels of brain-derived neurotrophic factor (BDNF) – a compound involved in learning and memory.

Use targeted supplements to support your brain

I like to top up with supplements as I don’t always manage my diet perfectly. Here’s what I’m taking regularly: Omega-3 (high DHA) – essential for brain structure and mood (and so many other things!); B-complex vitamins – to regulate homocysteine (also good for energy, hormones…); Alpha-lipoic acid (ALA) – this is worth reading up on, it’s very protective of the brain; Vitamin D – we all know Vit D crucial for mood and cognitive health, especially in Ireland; Magnesium – to support our nervous systems, and also good for our brain health.

My goal for the next decade is to really focus on my brain health. The more I read and learn, the more I realise there’s so much we can do. Exercise, regular socialising, good sleep, and perhaps cutting down, or even cutting out, alcohol all come up again and again in the research on protecting our brains.

What I found most reassuring about Patrick Holford’s approach is how ‘wholistic’ it is “If we get our diet and lifestyle right for our brain, they’ll also be right for our body,” he said, and that really resonates with me. Even small changes like the ones above can make a meaningful difference to our brain health, while also supporting our overall wellbeing.

I also like the fact that if you log on to the Food for the Brain Foundation website, you can do a free cognitive test to assess your risk, and then order a homocysteine test for more insight. It feels empowering to have tools like this, small ways of keeping an eye on things and taking action early.

Good luck and let me know if you have any natural health questions I can help with! 

A natural beauty, exuding calmness, confidence, and a quiet dignity, Fiona Carson grew up on the family farm about four kilometres west of Schull, where she lives today after converting the ruins of an old building where she played as a child into her home. Fiona speaks proudly of her roots. Her maiden name, O’Mahony, has a long and rich history in this part of West Cork. The O’Mahony clan once ruled a significant part of West Cork in the early seventeenth century. Fourteen of their castles were built along the coastline, and many of them still remain today. The closest to Fiona’s home is Leamcon Castle, while one of the oldest is Dunlough Castle, also known as ‘Three Castle Head’.

Fiona works remotely as an accountant for a group of companies based in Killarney. Working this way allows her to stay at home and enjoy life surrounded by nature.

She tries to spend as much of her free time outdoors as possible. She loves long walks along the country roads with her collie, enjoys gardening, and in summer swims from the local pier about a mile from the house. Another of her passions is yoga.

Interestingly, there was once a very different side to her life – together with her husband, she competed in ballroom dancing. At that time, her wardrobe was full of long, flowing dresses embellished with sequins and crystal jewellery. These days, she rarely thinks about fashion, as most of her time is spent at home or around the village. But when an occasion does arise, she still enjoys wearing something beautiful and elegant, although comfort always remains her priority.

For Fiona fashion comes down to personal taste. If a person carries themselves with confidence – head held high and shoulders back – they can look wonderful in any outfit. She also believes that women today are placed under too much pressure, even when it comes to something as personal as hair colour. She has chosen to embrace natural change and calmly watches her hair gradually transform from brunette to a beautiful silver shade.

When I invited Fiona to take part in my photoshoot, she was surprised. But she decided to take the opportunity – to step outside her comfort zone and try something completely new.

Look 1

A beautiful example of modern understated elegance, where comfort and style are perfectly balanced.

The main focus is a soft beige poncho with fringe. Its relaxed silhouette creates beautiful movement and brings a sense of lightness to the outfit. The chocolate roll-neck underneath adds depth and makes the look feel more polished and composed.

Slim turned-up jeans balance the volume of the top, while leopard-print ballet flats bring character and a contemporary edge – exactly the kind of detail that makes an outfit feel alive and interesting.

The accessories are kept simple and considered: statement earrings and wide bracelets support the colour palette and add individuality.

This is the look of a modern woman who chooses comfort while remaining elegant.

Stylist’s tip: If you wear volume on top, always balance it with a slimmer shape below or show the ankle – it visually lengthens the silhouette and keeps the outfit feeling light.

Look 2

Depth of colour and understated femininity with character.

A monochrome look in a rich turquoise-blue shade creates a refined, elegant silhouette. The pleated dress adds softness and movement, while the leather jacket structures the outfit and brings in a sense of modern confidence.

The jewellery becomes the main accent here – a bold necklace and matching earrings deepen the colour story and make the look more expressive, almost artistic.

Simple shoes complete the composition without drawing attention away from it.

This is the look of a woman who combines strength and refinement while staying true to herself and her personal style.

Stylist’s tip: Don’t be afraid to build an outfit around one colour – play with different textures, such as leather, knitwear, and silk, to make it feel layered and stylish.

Look 3

Confident eclecticism.

The paisley-print dress sets the tone: feminine, dynamic, and instantly eye-catching. The soft silhouette and midi length make it versatile, while the belt defines the waist, adding structure and balance.

A contrasting leather jacket brings modernity and a subtle edge to the look – it is exactly this element that grounds the romantic feel of the dress and makes the outfit feel more current.

The accessories work as accents: a small textured bag and jewellery in turquoise tones echo the print, creating harmony in the details. Gold-toned shoes add light and a sense of completion.

This is the look of a woman who is not afraid to combine prints, textures, and character – and does so with ease and natural confidence.

Stylist’s tip: With a strong print, add one grounding piece – such as a leather jacket. It makes the outfit feel modern and stops it from looking too dressy or overloaded.

Stylist and photographer: Galyna Zaitseva.

To answer these questions, we need to start by looking at the nervous system itself. The nervous system consists of the central nervous system comprising the brain and spinal cord and the peripheral nervous system, which is a network of nerves that connects the brain and spinal cord to the limbs and organs. This vast system of nerves, approximately 45 miles long if we were to lay it out, is responsible for 100 per cent of our body functions. It is the body’s communication and control network. The nervous system detects the information in our environment, processes it and then sends signals throughout the system that co-ordinate movement, sensation, and bodily functions. It is always listening to the inner environment of the body and detecting the external environment, and it is the nervous system that determines our movement patterns. How we move through the world and indeed how we perceive it, is down to our nervous system.

Our sciatic nerve, which emerges from the spine, is the longest and thickest nerve in the body. It runs from the lower spine through the buttocks and down the back of both legs, terminating at the foot. It enervates the leg and carries the motor signals to the muscles, resulting in our being able to move our legs.

Just like our joints and our fascia, our nerves require movement to stay healthy. Nerve cells, interestingly, are known to be the most excitable cells in the body. They both love and require novelty to be healthy. From a movement perspective this means multi-directional movement is essential. Not only does multi-directional movement excite the nerve cells in the peripheral system, it also lights up the brain, as synaptic activity or signal transmission keeps the brain alert and firing in response to the inner and outer environment. Quite literally, without movement our brains become dull. And we need regular movement in many directions in order to support blood flow and drainage for the nerves. This is an especially important factor in sciatica prevention.

So how can we distinguish the pseudo from the real sciatica?

Real sciatica results from nerve compression in the spine. This can be as a result of injury to the back, herniation of the disc, known colloquially as a ‘slipped disc’ or stenosis. Such impingement upon the discs causes shooting, burning electric pain down the leg with the pain manifesting below the knee as the sciatic nerve doesn’t supply so much sensory function in the thigh. Sciatica usually resolves in four to six weeks, and pain relief may be needed. Pain is often, though not always, worsened by actions such as coughing, sitting, or placing load on the spine. Major red flags for sciatica are if pain runs down both legs, weakness or numbness develops down both legs or there is a loss of continence in either bladder or bowel. These are the symptoms of cauda equina, a rare but serious medical condition whereby the nerves at the base of the spine are severely compressed. It requires immediate surgical intervention to prevent loss of motor function or paralysis.

Pseudo sciatica is a milder creature and manifests more as neural tension and restriction. One sure sign of this type of sciatica is that symptoms will change depending on the limb positioning. For instance, if you pull your foot up towards you, which automatically shortens and tightens the sciatic nerve, you’ll feel an uncomfortable pulling sensation. This condition typically occurs with muscle stiffness or limited movement, but motor function remains intact. Poor hip mobility can also create symptoms of fake sciatica as tight or weak buttock muscles can impinge upon the nerve causing a literal pain in the butt. This condition may cause persistent discomfort, but it does not radiate pain to the lower extremities. Nerves enjoy movement but dislike strain. The brain responds defensively to stretching of major nerves, such as the sciatic nerve, due to their heightened sensitivity. This can result in ‘stuckness’ which can look like stiff ankles, tight hamstrings, hips and lower back. 

Managing both the real and fake

With real sciatica, once the episode has passed it is crucial to begin to strengthen the core to support the lower vertebrae and take pressure off discs and nerves especially where there has been a herniation. In the case of stenosis, learning how to move the spine with awareness is crucial. While there is no guarantee that you will not be revisited by sciatica, recovering confidence to move safely is vital. Remember nerve cells thrive on novelty and movement. Because the brain will ‘guard’ tight nerves we can end up limiting our movements to avoid pain and lose so much more in our capacity to experience the world. We must proceed gently but with confidence. 

For both, stretching the nerve should be replaced by gliding the nerve. Gentle flexion and extension of the foot (pulling the foot up towards you and then pointing it away, exhaling as you pull towards and inhaling as you point away) is a simple way to start. Avoid doing too much at first, as it can be exhausting and may worsen symptoms. If you experience a flare up, wait for it to subside before continuing.

I would like to recommend a lovely modality called nerve brushing. Stand and place both hands on the abdomen and begin to brush down as though you are brushing crumbs off your clothing. Proceed your legs to your feet then brush down the chest and arms and head. Keep your touch light. Once you have brushed down the body return to the abdomen and proceed to brush in an upward direction through the whole body as before. This has the effect of lightly stimulating and relaxing the nerves and disarming the alarm system in the brain and makes stretching and gliding gentler so you can restore your sciatic nerve to health.

Cosmeticorexia is an emerging psychological pattern defined by an intense and persistent preoccupation with physical appearance, often driven by unrealistic beauty standards and amplified by constant exposure to curated digital imagery. While interest in appearance and self-care is a natural part of human behaviour, cosmeticorexia moves beyond this into a space where appearance becomes central to identity and self-worth. It is not simply about wanting to look good; it is about feeling that one must look a certain way to feel acceptable, valued, or even safe within social environments. In this sense, cosmeticorexia reflects a deeper internal struggle rather than a surface-level concern.

We increasingly observe that individuals caught in this pattern respond not to how they actually look, but to how they believe they should look. This distinction is important because it highlights the role of perception rather than reality. The internal experience is often characterised by dissatisfaction, comparison, and a constant sense of falling short. Even when changes are made, whether through grooming routines, cosmetic products, or aesthetic procedures, the relief tends to be temporary. A new perceived flaw quickly replaces the previous one, creating a cycle that is difficult to interrupt. The pursuit becomes endless, not because the desired outcome is physically unattainable, but because the internal standard keeps shifting.

At a psychological level, cosmeticorexia is closely linked to feelings of inadequacy, fear of judgement, and a fragile sense of self. The focus on appearance becomes a way of managing these feelings, offering a temporary sense of control. When life feels uncertain or emotionally overwhelming, the body can become a project – something to fix, refine, or perfect. However, this sense of control is often misleading. The more attention directed towards appearance, the more sensitive and critical the individual becomes, leading to increased dissatisfaction rather than resolution. What begins as an attempt to feel better can gradually turn into a source of distress in itself.

The role of social media in reinforcing cosmeticorexia cannot be overstated. We are now exposed to an unprecedented volume of images that present highly edited, filtered, and curated versions of reality. These images are often perceived as normal, even though they are far removed from everyday human experience. As individuals scroll through these representations, comparison becomes almost automatic. The mind begins to measure itself against an ideal that is not only unrealistic but constantly evolving. In this environment, appearance is not just observed; it is evaluated, ranked, and publicly validated. The number of likes, comments, and shares can become a proxy for worth, further embedding the belief that how one looks determines how one is valued.

Over time, this creates a powerful feedback loop. Exposure to idealised images leads to internal comparison, which generates dissatisfaction. This dissatisfaction then drives attempts to improve appearance, which may result in short-term validation. However, this validation is rarely stable, and the individual soon returns to a state of self-criticism. Each cycle reinforces the underlying belief that something is not quite right and needs to be fixed. The individual becomes increasingly focused on perceived flaws, often magnifying them beyond their actual significance.

Behaviourally, cosmeticorexia may present in a number of ways. Individuals may spend excessive amounts of time examining their appearance, taking photos, or adjusting specific features. Daily routines can become dominated by grooming, skincare, or makeup rituals, sometimes to the point where they interfere with other aspects of life. There may also be a growing reliance on cosmetic procedures or consultations, accompanied by extensive research into ways of altering or enhancing appearance. Emotionally, self-esteem becomes closely tied to how one looks on a given day. A minor imperfection can have a disproportionate impact on mood, leading to anxiety, frustration, or withdrawal from social situations.

Cosmeticorexia also shares common ground with other psychological conditions. It overlaps significantly with body dysmorphic tendencies, where individuals fixate on perceived flaws that may not be noticeable to others. It can also intersect with disordered eating patterns, particularly when body image becomes central to identity and control. In some cases, obsessive-compulsive features may emerge, with repetitive checking or corrective behaviours becoming difficult to resist. These connections highlight that cosmeticorexia is not a superficial concern but a complex and multifaceted issue that sits within a broader psychological context.

One of the most significant underlying themes in cosmeticorexia is the relationship between appearance and identity. Instead of developing a sense of self based on values, experiences, and relationships, identity becomes increasingly tied to how one is perceived externally. The question shifts from “Who am I?” to “How do I look?” This shift can create a fragile sense of self, as it relies heavily on external feedback and is vulnerable to change. If appearance becomes the primary source of validation, any perceived imperfection can feel like a threat to one’s overall sense of worth.

Teenagers are particularly vulnerable to this pattern, as they are in a stage of life where identity is still forming. Peer relationships and social acceptance carry significant weight, and the desire to belong can intensify the focus on appearance. When combined with exposure to idealised images and the pressure to present oneself in a certain way, cosmeticorexia can develop as an attempt to navigate these challenges. What may begin as curiosity about beauty or self-expression can gradually evolve into a more rigid and critical relationship with one’s appearance.

The long-term impact of cosmeticorexia can be profound. Emotionally, individuals may experience ongoing dissatisfaction, anxiety, and a diminished sense of self-worth. Behaviourally, significant time and financial resources may be directed towards maintaining or altering appearance, sometimes at the expense of other areas of life. Relationships can also be affected, as the focus on appearance may interfere with authentic connection. When self-worth is externally driven, it can become difficult to engage in relationships from a place of confidence and stability.

Addressing cosmeticorexia requires a shift in focus from external appearance to internal experience. This involves recognising that the urge to fix or change appearance is often linked to underlying emotions rather than actual physical flaws. Developing awareness of these emotional drivers can create space for a different response, one that does not immediately involve action or correction. It also involves challenging the patterns of comparison that are so deeply ingrained, particularly in digital environments. Reducing exposure to unrealistic content and questioning the assumptions it creates can help to weaken its influence over time.

Ultimately, cosmeticorexia reflects a broader cultural emphasis on appearance as a measure of value. It invites us to consider how identity is shaped and what we prioritise as a society. When appearance becomes the dominant lens through which we view ourselves and others, we risk losing sight of the qualities that make us fully human. Moving beyond this requires a rebalancing, where appearance is recognised as just one aspect of identity rather than its foundation. In doing so, we create the possibility for a more stable and authentic sense of self, one that is not dependent on constant adjustment or approval.

Now indoors with the door and windows wide open, I can still feel a gentle sea breeze brushing against my face and arms and circulating my little home here. My feet are bare, toes touching the ground and heels resting against the legs of the chair. All is well in this moment, this perfect moment of awareness, appreciation, and of living life fully. I love the simplicity of soaking it all in, this intentional taking in the good and savouring it. I take time to feel my body against all the surfaces, the ground, the chair, my elbows on the table or armrest, fingers touching the keyboard, and I repeatedly sense into the moment, almost exaggerating this momentary awareness of being present in this body, with no pressure, nothing to do, nowhere to go. Resting in the embrace of nature and this amazing natural world.  

And maybe because this dry, calm, sunny weather has been so rare this year, it seems extra precious and, I’m sure like most people, I want it to stay. We naturally want these good times to last, however, by the time it took me to move indoors, because the sun was cooling, I had received news of the deaths of two people I knew. A stark reminder that life is so unpredictable and can change in the blink of an eye. All the more reason for us to value our lives and the people and places we hold dear.  I pause and intentionally think of these affected families and a feeling inside of me stirs. Their grief resonates with me, and I feel deep discomfort and a sense of deep compassion for them.  

Compassion-based mindfulness encourages qualities like empathy, inclusion, solidarity and having the ability, as well as making the choice, to step into someone else’s shoes and offer compassion.

But while we can make choices every moment of our lives about how we live them, we really have no control over events that happen every day. So, there is something about noticing and relishing the good moments while accepting their impermanent nature and being able to sit with and accept the difficult moments too, instead of resisting them. Having the knowledge that a day going so smoothly and perfectly can be instantly interrupted can help us to be very grateful for those moments in the sun and our leisure time, simply because nothing stays the same for too long.  

Nature can be so reassuring amid all that’s happening within us and around us. It is a constant in our lives and yet always in a state of flux and flow. The amazing, heroic swallows are back and that fills so many of us with joy. To sit and watch them swooping and circling, imagining all they went through to get back here is truly awe-inducing. Perhaps our everyday mindfulness practices this month can be to garner moments of comfort from simply sitting listening to the birds or quietly watching the swallows. Can we put our phones and the news aside for a small while and feel the life that is bursting forth at this time of year? This poem ‘Allow’ by Danna Faulds is a nice one to contemplate.

‘There is no controlling life. / Try corralling a lightning bolt, / containing a tornado. Dam a

stream and it will create a new / channel. Resist, and the tide / will sweep you off your feet.

Allow, and grace will carry / you to higher ground. The only / safety lies in letting it all in – / the wild / and the weak; fear, / fantasies, failures and success. / When loss rips off the doors of / the heart, or / sadness veils your / vision with despair, practice / becomes simply bearing the truth. / In the choice to / let go of your / known way of being, the whole / world is revealed to your new eyes.’

Mindfulness in May

Drop-in mindfulness hour at CECAS, Myross Wood, Leap on Tuesday mornings 10-11am, May 12, 19 and 26. €12. 

Beginners, returners and newcomers are always welcome.
For more information: phone: 087 2700572 or email:
susanoreganmindfulness@gmail.com 

FB: susanoreganmindfulness. www.mindhaven.ie

by Melissa Byrne & Gillian Hegarty

One of the tastes of summer is most definitely that of a fresh strawberry, eaten in the (hopefully!) West Cork sunshine. In West Cork, we are so lucky to have Union Hall and Bushby’s strawberries on our doorstep. What makes our local strawberries special is not just our rich West Cork soil, but the way they are grown. Instead of using harmful pesticides to manage pests that might damage the crop, Bushby’s uses other beneficial insects in a preventative role. This means what ends up on your plate is as clean and natural as it gets. Hotels, restaurants and food lovers across West Cork all make local strawberries their preferred choice, for that exact reason. And if you’ve ever tried them, you’ll know what we mean. 

Strawberries are packed with Vitamin C, so one small bowl gives you more than your daily dose. They are also full of fibre, which is great for your gut, and they have natural sugars that give you energy.

This summer, keep an eye out for the Alpine strawberry, a tiny wild strawberry, which you might know as sú talún fiáin in Irish. It grows in hedgerows, along woodland edges and on grassy banks .These are much smaller than the ones you buy, but the flavour is intense and sweet in a way that is hard to describe until you have tried one. Top tip: you might find some near the playground in Dunmanway! Wild strawberries are perennial, meaning they come back every year in the same spot once established.  

Strawberries are one of the easiest fruits to grow at home: in a garden bed, a pot on a windowsill, or even a hanging basket. They like sunshine and well-drained soil. Plant them in spring and you could be picking your own by June or July. Once the plant finishes fruiting, it sends out runners, which are long thin stems with a baby plant at the end. You can pot those up and they will grow. So one plant can become many.

Strawberry frozen yoghurt pops

We have a tasty – and healthy – recipe for you! These frozen strawberry pops are brilliant on a warm day and they could not be simpler to make. You will need ice lolly moulds, which you can find in most supermarkets or hardware shops.

You will need:

•  250g strawberries

• 120g natural yoghurt

• 1 tablespoon of honey

There are two ways to make these: You can either just blitz the strawberries in a blender and freeze in moulds – these are delicious on their own, and great for teething babies, too.

Or, combine with the ingredients above. If you don’t have fresh strawberries, frozen is fine! Mix in the yoghurt and honey and stir until combined. Pour into your lolly moulds, insert the sticks, and freeze for at least four hours, or overnight. To release, run the outside of the mould briefly under warm water.

Tips: Strawberries freeze beautifully on their own too. Take out the stems, and freeze in a bag. Frozen strawberries are perfect for smoothies, porridge toppings, or blitzing into a quick sauce for pancakes.

Fruit skewers with chocolate dip

Thread chunks of strawberry, banana, apple, and whatever fruit you have, onto wooden skewers. For a dip, melt a bar of good dark or milk chocolate in a bowl set over hot water, stirring gently until smooth. Dip and eat immediately.  

Chocolate-covered strawberries

Wash and dry a punnet of strawberries and set aside. Line a baking tray. Melt good quality dark chocolate (we like 70pc cocoa). Dip strawberries into it and lay out on a baking tray to harden. Pop in the fridge or freezer and enjoy once chocolate has set.

Did you know?

Unlike most fruits, the seeds of the strawberry are on the outside. If you’ve ever bought a packet of strawberry seeds, you’ll know that they are tiny: those tiny yellow specks you see on the skin. A strawberry is not actually a berry at all, in the botanical sense. Bananas and avocados are true berries. The strawberry, meanwhile, belongs to the rose family, which perhaps explains why it smells so good.

We love the surprises Irish holds: ‘sú’ is from Old Irish, meaning juice or berry, and ‘talún’, comes from ‘talamh’, meaning earth or ground. So strawberry means ‘berry of the ground’ or ‘ground berry’.

Fun Facts

• The average strawberry has around 200 seeds.

• Strawberries were used in medieval times to treat everything from fevers to sore throats.

• The world’s heaviest strawberry on record weighed 289g, roughly the same as a small tin of beans.

• In Japan, strawberries are so precious that a single perfect fruit can sell for several euros.

Follow us for more news about our cooking and gardening workshops in West Cork schools: Instagram: @kidsfoodrevolution. Newsletter: kidsfoodrevolution.substack.com. Website: www.kidsfoodrevolution.com.

For me, like many of us, food and wine is an essential element of travel. In my case, wine plays a leading role. Apparently the ancient Romans had a similar outlook, some theorising that their empire extended only to the limits of where wine could be produced. This is not a historical fact, I might need to clarify it with the more qualified historians in this very paper!

Wine provides a perfect route for exploring, though. Our European neighbours have great diversity in their wine styles and regions, a path which leads to discovering more about a country’s food, history, language and culture. 

Travelling by car is the easiest way to explore wine country, as vineyards are usually outside of the main centres. That said, there are always tours into the heart of the wine regions which can be booked for a day trip, or a bike tour, though be careful on that bike after a few samples.

I love to see a hand-painted sign pointing down a farm track. This usually promises a more interesting experience than a swish, glass-fronted building in the centre of town. Here, you’ll meet the winemaker with her husband, sister and grandad, see where the vines grow, smell the fermenting juice in the cellar, and hear the story of the business, often going back generations. Many also offer agri-tourism, or ‘agriturismo’ in Italy – farm stays where you are immersed in the local food and wine, seeing the production all around you, whether vines, olive groves, vegetable gardens or farm animals.

When we’re eating in restaurants on holiday, I always ask for the most local wine, which is generally the best wine to pair with the local food. It also regularly leads us on a journey. Last year, in Bayonne, the wine we were recommended was from Irouleguy, a tiny Basque wine region I had never heard of. I looked up the vineyard and called them, arranging a visit the next day. We travelled up into the foothills of the Pyrenees, to St. Jean Pied de Pont, a town milling with pilgrims starting the Camino de Santiago de Compostela. We tasted their wines surrounded by vines, were given chunks of a sister’s sheep’s cheese, and the spicy local Espellette pepper. We heard of the survival of their own language in the area, the winemaker’s children going to the Basque equivalent of the Gaelscoil in the town. 

In north-east Italy, look out for a ‘Frasca’ sign on the side of the road. This will lead you to a farm which produces wine and serves simple snacks of cheese and salami. You’ll eat and drink outside at a wooden table, and meet the people who are producing your meal. It’s a delicious way to learn about the area, always discovering a new grape variety or method of production. 

In Sardnia, we learned a valuable lesson. We hired bikes to cycle to a famous vineyard a few kilometres outside Alghero. The road was narrow and busy, the vineyard glossy and soulless. When we returned the bikes and told of our experience, the owner told us of a gorgeous small winery he would have recommended, reachable by an off-road cycle track. Now I know – ask the bike shop guy where to go, not Google.  

I don’t think it’s a coincidence that the best food is found in the heart of the wine-producing regions. Vallidolid in northern Spain is close to many wine regions, producing a range of styles to please every wine lover. The food in the town is among the best in Spain, whether you graze on tapas or sit down for the works. You’ll drink wines by the glass from the region, and you are always rewarded by asking for a recommendation, rather than playing safe with the name you recognise.

Every region has its own distinct grape varieties, making a style of wine which reflects where it comes from. It is the best wine to drink with the food of the area, as they have grown up together over centuries. Markets are another great way of discovering local wines, as there are often a few local producers showing their wares. They are always keen to talk about the history of their farm, explain the different wine styles they produce, and the ideal food to go with their wine is found close by on the other market stalls.  

Heading off in search of these small vineyards in remote places has led us to discover parts of the country we would otherwise have never found, and met people who gave us an insight into the heart and soul of the region.