This paper documents 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. The authors report on 2 qualitative studies: one in which 35 women (aged 20–89 yrs) in South Wales were interviewed about their main health concerns and a similar study in Ghana, West Africa which included interviews with 75 women (aged 20–80 yrs). Women's accounts of their distress are set in the context of 3 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. The authors 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.