Menstrual hygiene is a vital as well as a very sensitive issue for women in reproductive ages. In general, women spend around six to seven years of their lives menstruating. Having a safe, personal and cultural environment to manage menstruation hygienically and with dignity is the right of every women. However, the ability to enjoy this right is often far from reality. One reason for this is that menstrual hygiene management is often neglected in general health agendas. This can be seen in emergency situations. Most temporary relief centres are not women friendly and therefore womens´ security, privacy and health needs are largely ignored. Especially in developing countries, menstruation is often handled in secrecy. In emergency situations, the normal life style of victims has changed and they are under immense psychological pressure which aggravates problems. Providing basic needs such as food and medicine gets priority while the pressing need of securing menstrual hygiene is often neglected. This paper explores the issue of menstrual hygiene management in emergency situations. It also discusses common obstacles that are encountered in promoting effective menstrual hygienic practices in disaster relief programmes. Learning from the Tsunami relief activities in year 2004, this article describes strategic actions to build capacity and develop processes to respond to the needs of menstruation women.