Speaking to BBC World Service she explained why her writings have repeatedly got her into trouble and why she continues to use words as her weapon.
"I started to have problems not only because I spoke of female circumcision," she said, "but also because I connected female circumcision to economic and political problems. This was my crime."
Danger
Having recently released the second volume of her autobiography, Walking Through Fire, Nawal El-Saadawi's compulsion to write has never been stronger.
"Writing makes me proud and happy," she told the Meridian Writing programme. "That is why I still am surviving."
For this author survival has been no mean feat.
As the first Arab woman to write against female genital mutilation, her radical writings have repeatedly got her into trouble.
"Capitalism and patriarchy live on pornography", she explained, "but I started to connect sexual oppression to economic and political oppression at the international and national level."
Death-list
Dr Saadawi's views on sacred subjects have in the past led to her imprisonment and censorship.
In the early 1970s she was fired from a ministerial job, and in 1992 her name was added to a Muslim fundamentalist death-list.
"It was a strange voice that invaded the night, it said, 'Wherever they are kill them. Kill the enemies of Allah'," she said of that time.
"Then came a list of names. Writers, poets, historians, philosophers - 30 or 40 names in a row and suddenly I hear my name and it goes through my head like a bullet."
Feminist physician
As a doctor, Ms Saadawi claimed that much of the illness that she saw was caused by poverty, ignorance and the routine abuse of women's bodies.
This, she explained, led her to write as a form of preventative medicine.
Her novels, including Women at Point Zero and God Dies by The Nile, have been described as fierce and passionate exposes of women's social and physical mistreatment.
However, despite often being labelled "a feminist", the author now chooses to distance herself from the title.
"This doesn't mean that I have changed my opinions. I am now a little bit cautious," she explained.
"I feel that there are some feminist groups in some countries, East and West, who speak about feminism in a very distorted and limited way."
Drawing strength from her convictions she added, "They separate sexual oppression from political and economic oppression.
"Since I started writing about women, now half a century ago, I never separated."