‘Real Housewives of Rhode Island’ spotlight menopause bill in R.I.
PROVIDENCE — The latest episode of “The Real Housewives of Rhode Island” focuses attention on an issue that has nothing to do with finger-wagging confrontations, infidelity, rumors, or pizza chips.
Instead, cast members Liz McGraw and Dolores Catania, visited the Rhode Island State House to talk to state Senator Lori Urso and Representative Karen Alzate about menopause legislation.
Urso, a Pawtucket Democrat, championed a bill that became law last year, making Rhode Island the first state to explicitly protect women experiencing menopause in the workplace under a fair employment statute, according to the Menopause Education Center.
This year, Urso has introduced legislation that would require private insurance to cover hormonal and non-hormonal treatments for the symptoms of menopause and perimenopause — the transition into menopause during which ovaries begin making less estrogen.
The Senate voted 37 to 0 for on May 28. But the House has not scheduled a vote, and this year’s legislative session is expected to wrap up Thursday.
On Wednesday, Urso said she is prepared to make the measure a priority next year if she’s reelected. But in the meantime, she said, little Rhode Island has played a big role in propelling a “movement” to talk about a topic that has long been taboo, and to pass laws that support women at work.
And now, the issue has received a boost by being featured in “The Real Housewives of Rhode Island,” a hit Bravo TV series that drew 2.7 million viewers for its first episode.
“This ‘Housewives’ thing can help change the culture,” Urso said. “We really need women to get out the shadows.”
When she first introduced menopause legislation in 2025, there were only about a dozen legislative measures related to menopause across the country, Urso said, including bills and resolutions.
But this year, there are about 70 such legislative measures in a dozen states, she said, including a law that the City of Philadelphia passed to protect employees from discrimination on the basis of menstruation, menopause, and perimenopause. In Massachusetts, Blue Cross Blue Shield has launched an online support group specifically for employees experiencing perimenopause and menopause.
“There is a movement in this country to open the dialogue on menopause, and to consider ways that we can legislatively expand provisions to combat stigma and discrimination while supporting education and treatment to improve outcomes for women,” Urso said. “Rhode Island has been at the forefront.”
Urso, 61, works as president and CEO of the Old Slater Mill Association, but she said she almost lost that job because of menopause symptoms.
For three years, she struggled to sleep, waking up with night sweats while dealing with heart palpitations, brain fog, and panic attacks, she said. Doctors did not immediately connect the symptoms to menopause, and she ended up submitting her resignation in 2020, she said.
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But then the pandemic hit, allowing her to work alone, and she returned to the job, Urso said. Once she received menopausal hormone therapy, she felt much better, and she began to realize that this is an issue that affects working women across the globe.
The United Kingdom has led the way in a supporting menopausal women in the workplace because officials there realized they were in danger of losing a big chunk of the workforce at a point when they had tons of institutional knowledge. With support, women can navigate a temporary condition and continue to contribute to their workplaces rather than retiring early and having their careers stunted, she said.
Too many women worry that they are experiencing more serious problems, ranging from heart problems to dementia, when they are coping with the effects of plunging estrogen levels, Urso said.
Too many doctors miss the signs of menopause, she said. Women typically experience the menopause transition in their 40s or 50s, with symptoms lasting between three and seven years. A range of medical treatments exist to alleviate these common symptoms, but one study found just 26 percent of women have full insurance coverage for menopause-related treatments.
Too many people have been reluctant to talk about menopause, Urso said. “This has not been in the culture,” she said. “It has been taboo to talk about. Women stay silent. But now younger women are refusing to stay silent.”
She said she has made a point to talk to male legislators about the issue and how it has affected their wives.
“When I first went to them, they kind of cringed, like ‘We don’t talk about that,’” Urso said. But now the topic is easy to broach, she said.
When she first introduced menopause legislation, Urso asked for time to go beyond a perfunctory explanation of the bill so she could talk to a Senate committee, consisting almost entirely of men, about why this is a significant workplace issue. She said male labor leaders were waiting to testify about a separate bill, and afterward they said her testimony was eye-opening.
“If we just educate men, they will support us,” Urso said. “They love us. They are co-workers. We have just been too silent about this for too long.”
Urso’s would require private insurers in Rhode Island to cover at least one medication, approved by the US Food and Drug Administration, in a range of available delivery methods, including oral, transdermal, topical or internal.
“This is important because for women with certain health risks, one form of the medication may be safer to use than another,” Urso said. “And we want to be sure the most suitable options are available to women to ensure that symptoms can be alleviated to improve their quality of life.”
Alzate, a fellow Pawtucket Democrat, has introduced companion legislation in the House. But the House Health and Human Services Committee has held that bill for further study.
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