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Handbook of Clinical Gender Medicine


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when assessing younger adults. Consequently, it will be important to determine meaningful subclinical ranges of biomarkers between the sexes and among ages.

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      The cumulative physiological toll of AL is consistently associated with increasing age in populations worldwide but is nevertheless even detectable in disadvantaged children and adolescents (table 1). From a developmental perspective, we observe that increased AL and senescence interact with a vast array of risk factors and protective factors that carry different health benefits or detriments that affect different age groups in particular. Specifically, such factors as social support, work/home balance, hostility, caregiving, and spirituality are gender typical and of clinical importance as they are steadily associated with increased AL.

      Gender Differences

      Evolution of Sex and Gender Differences in Stress

      Treatment

      Fostering Resilience

      Specifically for the elderly, well-being therapy that emphasizes autonomy, purpose in life, personal growth, positive relations with others, environmental mastery, social activities, and self-acceptance could be coupled with more traditional cognitive and physical interventions [8]. These person-centered approaches to diminish AL collectively represent viable alternatives or complements to pharmaceutical strategies, although these must also be considered amid conceptual reluctance.

      Pharmacotherapy

      The effects of chronic stress can be reduced via pharmaceutical agents such as sleep medications, anxiolytics, antidepressants, and β-blockers as well as by drugs that reduce oxidative stress and inflammation such as statins, insulin resistance treatments, and analgesics [20]. However, there are counterarguments against pharmaceutical remediation, especially as they pertain to the widespread systemic dysregulations inherent in AL. In the original formulation of the allostasis concept, Sterling and Eyer [5] argued that medical practices based on homeostatic models were in danger of iatrogenesis (ailments brought forth by a healer) and polypharmacy as treatment problems can arise when correcting one parameter causes dysregulation among other systems. Ultimately, the challenge is to develop pharmaceutical treatments with minimal side effects and inadvertent recalibrations of subsidiary systems. Because AL represents multisystemic, subclinical dysregulations predating the emergence of clinical outcomes, treatment options targeting the aforementioned psychological, behavioral, cognitive, and social domains could be complimentary and indeed facilitative towards improving efficacy and compliance to low-dose pharmacotherapy aimed at proactive prevention instead of reactive prescription.

      Future Directions

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