Co-writer Dick Wagner told Songfacts:

I wrote the music for it in 1968. I was with the Frost, my band in Detroit. I had lyrics for it, but they weren’t good enough. I never recorded it because I never really got the song finished lyrically as far as that was concerned. So when I got together with Alice in 1975, seven years later, I played him the song that I had. He didn’t like the lyrics either, but he told me he had a title that he’d been wanting to write, but he hadn’t been able to find music for it yet. He said it was called “Only Women Bleed.”

So we sat down and took his title and my music and he came up with almost the rest of the lyrics. But it’s really a song about domestic violence. It was misunderstood when it first came out. It was supposedly about a woman’s period, but it wasn’t. It was about a woman’s subservient position in society to a man. I’m a firm believer that women are the superior sex. “Only Women Bleed” was a liberating kind of song.

The music I had written was a little bit unusual, but it was really good, so the writing was a pleasure. And the actual recording of it was fantastic. Bob Ezrin did a great job with producing that song. It’s been recorded by like 30 different artists, so it’s obviously got some staying power. Every year somebody records it.