IT'S one of those 'embarrassing' issues that women are sometimes afraid to raise even with their doctors, but the medics say it's an issue that affects many women, and for many different reasons.

Gynaecologist and obstetrician at the University Hospital of the West Indies Professor Horace Fletcher says vaginal laxity, or vaginal looseness, can occur due to a number a reasons, and affects women of all ages and types, despite various myths and stereotypes.

The causes can range from uncontrollable illnesses to damage caused from childbirth.

"Childbirth injuries, for example, are more common in unsupervised deliveries where women start pushing before they are ready (fully dilated) and in women who have uncontrolled deliveries where the baby comes out very quickly," Professor Fletcher explained. "It can also occur from instrument deliveries such as forceps in the hands of the unskilled."

Some reasons the gynaecologist gave for vaginal laxity are:

1. Childbirth (delivery of a large baby, delivery of many babies, a traumatic delivery).

"The damage is to the pelvic floor ligaments," Professor Fletcher explained. "The vaginal muscles can compensate somewhat for this damage and vaginal exercises -- Kegels -- on these muscles can help with the laxity."

2. Menopause (usually in women with childbirth damage to the vagina).

"The vaginal muscles get weaker after menopause with loss of oestrogen," he said.

3. Congenital Lack of collagen.

"Some women, even without having children, have weak pelvic floors because of weaknesses in the ligaments as a genetic problem," the professor said.

4. Excess sexual activity.

"This can result in some increase in the vaginal capacity," he explained. "However, the degree of looseness is mild compared to women who have damage from childbirth."

5. Repeated insertion of large foreign objects.

"Some women, especially sex workers, insert large objects in their vaginas. This can eventually stretch the vagina and lead to laxity," Professor Fletcher said.