Regular menstruation signals a woman’s health and fertility. Yet, menstruation is surrounded by shame, secrecy, embarrassment, fear, humiliation, silence, taboo, and stigma. Linked to this taboo, many cultural and religious norms often grounded in patriarchal assumptions seek to prevent contact with menstruating women and girls in order to avoid ‘contamination’ or ‘becoming impure’. Against this background, this article explores challenges for menstrual hygiene at the practical and policy level. It examines how menstrual hygiene is situated in the human rights framework, in particular gender equality, how menstrual hygiene can be defined in human rights terms and how using the framework of human rights and substantive equality may contribute to giving menstrual hygiene greater visibility and prioritizing the development of appropriate strategies and solutions.