Pharmaceutical treatises are a rich untapped source for the social and cultural history of women in the medieval Islamic world. Originally influenced by the medical treatises of Greek physicians such as Hippocrates and Galen, this genre gained popularity for its practical uses, and many Arabic works achieved a broader reception in Persian and Turkish translations. Most scholarly attention has focused on these texts’ scientific significance, while social and cultural historians have approached them primarily for their views on sexuality. Rather than pure lists of pharmaceutical recipes, these texts often incorporate stories and narrations about how these concoctions are to be used and in what circumstances. Thus, while focusing on the sexual health of women and men, these works offer a collection of narrative scenarios in which women are shown to exercise agency. By reading these works with women in mind, they can be used to recover details of medieval women’s daily experiences. A treatise known as al-Īḍāḥ fī asrār al-nikāḥ (The Explanation of the Secrets of Marriage), written by the twelfth-century Syrian physician, poet, and judge ‘Abd al-Raḥmān b. Naṣr b. ‘Abdallāh al-Shayzarī, is an exceptionally popular specimen of this genre. This work is dedicated to the sexual health of men and women and is divided into two sections: one entitled Asrār al-rijāl (The Secrets of Men) and the other Asrār al-nisā’ (The Secrets of Women). This paper examines this work from two different perspectives. First, I analyze the work itself, reading its anecdotes against the grain to reveal ways in which women wielded agency. Second, I examine the long afterlife of this text, including its translations into Persian and Turkish. Although originally written in Arabic, Shayzarī’s Īḍāḥ had a lasting influence, especially in the Ottoman Empire, and analysis of its contents and its reception may demonstrate both how cultural attitudes toward women changed over time, as well as the interconnectedness of the Arabic, Persian, and Turkish literary traditions.