A new study from the University of Iowa finds that women are less likely to get help for a drinking problem and are more likely to believe the problem will get better on its own.

The study, which digs deep into the differences in the way men and women handle excessive alcohol consumption, suggests that different strategies for dealing with the problem should be developed for men and women.

“We should ask ourselves, ‘How can we tailor services for women? How can we improve problem recognition? What messages will encourage women who have drinking problems to get help?’” says Paul Gilbert, assistant professor of community and behavioral health in the UI College of Public Health and the study’s lead author.

The survey confirmed the results of past studies, which found that the majority of adults with alcohol-use disorders do not seek help from specialty clinics or community-based groups, such as Alcoholics Anonymous. The survey also confirmed that women are less likely to utilize these alcohol services than men. But Gilbert says the survey-data analysis is the first to examine differences in specific reasons why adults don’t look for help.

He says that a similar number of men and women cite embarrassment as their top reason for not seeking help, or a belief that they should be strong enough to stop drinking on their own.

But he also found stark gender differences. Women were much more likely than men to believe their problem will get better on its own—47 percent, compared to 23 percent for men.

Men, meanwhile, were more likely than women to report having failed in previous attempts to get help (19 percent, compared to 3 percent of women) or thinking that nothing could help them (17 percent, compared to 5 percent for women).

The study analyzed data gathered in a random survey of Americans by the National Institutes of Health asking general health-related questions. The first survey was taken in 2000 and 2001, and the respondents were asked to complete a second survey in 2004 and 2005. Gilbert’s study analyzed about 2,600 of the respondents who participated in both surveys and whose responses indicated they met the criteria for alcohol abuse or dependence.

“Men and women think differently about how they overcome alcoholism,” says Gilbert. “Women are more independent-minded and self-reliant, thinking it can be done independently. Men are more pessimistic based on failed past experiences, or they don’t know where to go to get help.”

Gilbert says the study doesn’t look at why women and men have such different views, but previous studies have found that women have more often sought treatment for alcoholism by using services focused on mental health issues in general instead of from individuals or organizations specializing in alcohol problems. Other studies suggest that women are less likely to acknowledge they have a drinking problem, so they don’t seek help for a problem they don’t believe they have—or they just don’t have time, given work and family commitments.

Gilbert says more women might be more likely to seek help if programs were developed specifically for them, such as women-only support groups or women caregivers.

Gilbert’s study, “Gender Differences in Use of Alcohol Treatment Services and Reasons for Non-Use in a National Sample,” was co-authored by George Pro and Grant Brown of the UI College of Public Health, and Sarah Zemore and Nina Mulia of the Public Health Institute in Oakland, California. It was published in the April 2019 edition of the journal Alcoholism: Clinical and Experimental Research.