Distress has been identified in women attending gynaecology outpatient clinics and yet, there is poor provision of psychological help for these women. The aim of this study was to investigate women's current preferences for possible psychological help and to explore factors relating to this. A questionnaire survey of 197 women attending gynecological clinics was carried out. Thirty-five per cent of women were experiencing clinical levels of anxiety and 13% clinically significant depression; half of the women reported feeling distressed. Thirty-six per cent of women had previously had some kind of help for psychological or emotional problems. Of the women who reported being distressed, 29% felt adequately supported by their friends and family, while 59% indicated a desire to talk over concerns with a trained professional counsellor. More women expressed an interest in individual, rather than group psychological therapy. Results suggest that women's desire for psychological help relates to their perceptions about their distress and its cause. In addition, expressed desire for help may not be matched by actual help seeking behaviour. Issues to consider in service provision are discussed in particular the need to respect women's preferences for treatment, and to offer a range of interventions, including intervention at an individual, group and at a systemic level.