It is a normal human tendency to ‘run for your life’ when an earthquake occurs. Adolescent girls and women of reproductive age leave their homes with only the clothes they are wearing to save their own and their families' lives. Immediate disaster relief aid with its (unintentional) lack of gender sensitivity has little or no materials for the appropriate management of menstrual hygiene. The biological needs of disaster-affected women will not change despite the dire need for basic food, shelter and security. Timely identification and preparation beforehand with appropriate and culturally sensitive techniques and locally available materials that are reusable can help introduce sustainable and acceptable means of managing menstrual hygiene in a crisis. The use of reusable sanitary towels is well accepted for menstrual hygiene management in non-disaster situations and is appropriate in post-earthquake relief in Nepal.