Discussions of the health of women in the developing world have typically been shaped by the concerns of policy makers, health care professionals and other experts. They have focused on reproductive health and, above all, women have been defined in terms of their childbearing role. Yet when women themselves are given a voice, a different set of issues emerges. The research reported here aimed to explore women’s own concerns about their health and how they understand their health problems. The study was conducted in the Volta region of Ghana and it included interviews with 75 women of varying background. Almost three-quarters of the women reported ‘thinking too much’ and many also said that they had problems sleeping, suffered frequent headaches and often felt unhappy or sad. They explain these psycho-social health problems in terms of their social and material circumstances and one of the main themes women emphasised was their relationships with men. Relying on women’s accounts, we trace the ways in which they conceptualised their health, seeing it as shaped by their lack of control over the conditions of their lives; gender relations define their responsibilities while at the same time withholding the control and resources they require in order to achieve a measure of economic independence and predictability