Build up the box, ladies.

As we age — and particularly before, during and after menopause — estrogen production is compromised and our below-the-belt bits take a hit.

“The vaginal wall collapses, it’s so real. Nobody’s talking about it. I think because it’s embarrassing,” Leslie Kenny, founder of Oxford Health Span and co-founder of the Oxford Longevity Project, told The Post.

That can lead to a host of health problems. But fortunately, there are things you can do about it.

What’s going on down there?

Your hormonal changes can have a major physical impact.

“With low or nonexistent estrogen, there is less blood flow to the vulva and vaginal tissue, causing dryness, shrinking of the vaginal opening, and less natural lubrication — [which can cause] pain, itching, irritation, burning and painful sexual penetration,” Dr. Sherry Ross, author and board-certified OB/GYN, previously told The Post.

Kenny said that the consequences of vaginal wall collapse, in particular, can be dire, leading not just to compromised intimacy but also to increased instances of urinary tract infections, which can cause life and limb-threatening cases of sepsis.

While some women opt for hormone replacement therapy (HRT) — which has been shown to lower the risk of Alzheimer’s, prevent both osteoporosis and heart disease, and lessen the effects of estrogen loss on vaginal integrity — Kenny noted that there are other ways to support and protect yourself.

“We’ve got to get women advocating for themselves because a lot of doctors don’t tell them the options.”

1. Sexual intercourse

Sex is a free and effective way to improve vaginal tone, according to Kenny.

“There’s a bit of use it or lose it here,” she said. “As women get older, if they are not on BHRT, or even if they’re on BHT but they aren’t having regular intercourse, what can happen is that the walls of the vagina can kind of close in on each other.”

And better yet, finishing strong can strengthen the pelvic floor.

“Orgasms in women strengthen pelvic floor muscles through rhythmic contractions, which help reduce urinary incontinence.”

2. Red light therapy

“A red light wand can be used to improve vaginal tone,” she added.

Red light wands like the one sold by Joylux combine thermal heat, vibration, and the light from red and infrared LEDs to rebuild collagen and elastin and tighten and tone vaginal tissue.

Experts say benefits can be felt in as little as two weeks.

Red light therapy can be used in conjunction with HRT, and because the treatment itself is hormone-free, it’s an excellent option for women who choose to forego HRT.

3. Vaginal suppositories with estrogen

Vaginal estrogen, in the form of creams or suppositories, can ease vaginal dryness and support tone and texture.

“Instead of being a desert or dry hosepipe, it gives suppleness, flexibility, and that mucosal lining comes back,” Kenny said.

Suppositories can also stave off UTIs.

“There is a reason why these older women who are actually not necessarily sexually active are getting all these UTIs, and it’s because they lose vaginal wall integrity, and with estrogen, you give it back.”

Kenny explained that these treatments are ideal for women who have been advised to steer clear of HRT.

4. Spermidine

As the name implies, spermidine is found naturally in sperm as well as breast milk, and the compound has been linked to a slew of health benefits, including improved brain health, immunity, cardiovascular resilience, overall appearance, and vaginal rejuvenation.

“A big benefit of spermidine is that it activates cell renewal,” Kenny said.

As women age, vaginal tissues begin to thin and spread apart.

“You want it to tighten up, and spermidine does that. Spermidine in breast milk helps the nascent lining of the baby’s gut seal up; the same thing happens with the lining of the vaginal wall,” she went on.

Women who have sexual intercourse without a condom can absorb spermidine from their partners.

“Spermidine inside the vagina helps with the integrity of the vaginal lining. And again, this is a problem for post-menopausal women because there’s so much dryness that the walls lose their integrity,” she said.

For those who do not have regular intercourse or intercourse with a male partner, spermidine supplementation is a viable option.

Read the full article here

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