Susann’s narrative exposes the excesses of elevated social circles and the celebrities who inhabit them, writing from her own experiences as a Broadway actress. She writes in the matter-of-fact tone of someone who moves freely through those circles. To the uninitiated, the behaviors the author describes seem outlandish, while to those Susann describes, this is actually mundane reality. Readers in 1966 would have been startled when Anne, wearing Allen’s engagement ring, has sex with Lyon and lies in bed having a candid conversation about birth control. The novel’s three protagonists casually discuss sex, abortion, drug use, and schemes to seduce or divorce men. Likewise, the novel does not shy away from depictions of misogyny, describing rape, unwanted sexual comments and conduct, and vulgar language reducing women to objects.

Before Valley of the Dolls, novels that centered on young female characters often depicted sexuality in euphemistic language. Even Truman Capote’s 1958 novella Breakfast at Tiffany’s, whose main character is a sex worker, speaks of sexuality only in coded language. Susann’s relaxed style startled the mid-60s reader by openly describing previously concealed realities about celebrities and those who deal with them.