In this paper we document women's own constructions of their psychosocial health and the way they trace the problems they experience to the social and material conditions of their lives. We report on two qualitative studies: one in which 35 women in South Wales were interviewed about their main health concerns and a similar study in Ghana, West Africa which included interviews with 75 women. Women's accounts of their distress are set in the context of three key issues: money problems, relationships with men and motherhood. Despite cultural differences in the expression of distress, the common themes point to the influence of gender relations and women's roles in production and social reproduction. We argue for greater documentation of the material and social circumstances of women's lives and their effects on women's health. In so doing, it is important to incorporate women's own accounts of their health.