Menstrual hygiene management (MHM) is a largely overlooked issue in the water, sanitation and hygiene (WASH) sector. Every day, millions of menstruating girls and women in low-income countries struggle to find clean water for washing, private places for changing and adequate blood absorbing materials. This study aims to explore the difficulties experienced by schoolgirls in Uganda in managing menstrual hygiene and investigates the extent to which low-cost sanitary pads are part of the solution. Low-cost sanitary pads, either re-usable or disposable, are a timely, simple and innovative means of improving menstrual hygiene and of addressing a broader set of problems related to MHM in schools. Other factors highlighted are: pain relief, education, safe water provision, clean and private latrines, hygienic and secure bathing facilities, use of soap, sealed waste disposal points, private drying places, anal cleansing materials and effective facility operation and management strategies.