This review of sanitation system trends and interactions with menstrual management practices has been conducted as part of the broader project on Menstrual Management and Sanitation Systems. It starts with a review of trends in the development of urban sanitation systems and then explores the interaction between menstrual management and sanitation systems, mainly relating to the issue of disposal of used menstrual blood absorption materials. Finally, it proposes a framework of interactions by positioning a range of issues of particular relevance for menstrual management into the different parts of the sanitation system.