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RS quoted a fascinating Gemara above, however there are a lot of ways it's interpreted. Don't get started on trying to psychologically diagnose "sort of kind of pikuach nefesh", unless you're a trained professional or it's clear this person is a danger to themselves or others (at which point you need to call in the professionals). Let's try and break down ...

If you know that you would be in such a situation, inform the woman, who may be trying to shake hands with you, beforehand, to avoid problems. During my service in Israeli army I attended an order where I was supposed to shake hands with one female lieutenant colonel in presence of other high-rank commanders. I informed her about my problem beforehand, and ...

The prohibition only applies to "derech chibah", so even without an object it would not be forbidden, though in practice it would not be recommended. However, with an object wouldn't be a problem. See the beginning of this Hakirah article by R.Y. Henkin: http://www.hakirah.org/Vol%204%20Henkin.pdf While poskim argue over what a handshake is classified ...

I once heard a fascinating answer in the name of Rav Shimon Schwab: The Gemara in Shabbat (86) says that through battling one's yetzer hara, one becomes warmed up. David, however, says R' Schwab, had no Yetzer Hara ("velibi challal bekirbi") so he became cold since there was nothing to battle. Thus, the only way to re-warm him would be to arouse his yetzer ...

I am a white male, and I had this happen to me recently, where I met a woman in a business setting who politely told me, "I don't shake hands for religious reasons". I had never heard this before, but it did not faze me in the least. She was polite in every other way that she treated me. No Problem!