Alice Bunker Stockham worked as a gynecologist and activist for women's rights and family planning; in Karezza she discusses the fundamentals of a successful marriage, whereby both partners are sexually and emotionally fulfilled.

For Stockham, a healthy marriage was one in which the woman enjoyed freedom to pursue her hobbies and activities; where sexual relations serve to strengthen and preserve the marital union; where a household is harmonious to the point of maximizing the offspring's chances of a successful life. Arriving at this ideal situation, whereby several ethical tenets are attained by the couple, is not easy - the author, using her career and experiences as a grounding, offers suggestions and practical advice in support of her treatise.

At the time Stockham published this text in 1903, there was little formal marriage guidance or counselling available. The notion that a married couple should consult a professional, that the union be steered back to prosperity and joy, was simply inconceivable. It is thus that Karezza, as a series of ideas and principles, was pioneering for its time. Stockham's arguments, soundly and eloquently stated, make the case for a successful marriage, and the social, psychological and spiritual benefits which result.