The Duke University Medical Center in North Carolina, one of the most prominent health and research institutions in the country, recently introduced a program tailored for female athletes. The Women's Sports Medicine Program at Duke is the second facility in the nation to address exercise and injury issues that are unique to women.

When Alison Toth was a basketball player at Yale University in the 1980's, she saw many of her team members suffer torn knee ligaments at a rate more than five times that of her male counterparts injuries that frequently marked the end of a career. Today, Alison Toth is an orthopedic surgeon at the Duke School of Medicine Duke's first female orthopedic surgeon and director of their new Women's Sports Medicine Program.

"Women have some unique issues, whether it's exercise and pregnancy, to something as simple as stress fractures around the feet, that women are pre-disposed to, due to the way they're aligned - there are a number of separate issues for women," she explains.

Dr. Alison Toth says that because men and women tend to get different injuries, there is a need to provide specialized care for active females. Dr. Toth, who also works with Duke's women's athletic teams, says there's a growing concern among doctors about a condition called the "female athlete triad," a combination of eating disorder, osteoporosis and amenoria the loss of a menstrual period-- which is often the result of extreme dieting and exercise.

"So women who are in their late teens, early '20's, are losing a lot of bone mass at a time when they should be building," she says. " And it really sets them up for trouble down the road when they're 40 or 50 [years old] and therefore, having stress fractures as a young woman, then osteoporotic fractures as a middle-aged woman as opposed to an elderly woman."

For years, says Dr. Toth, medical research was based on the presumption that there was little difference in treating men and women's health issues. But she says that is changing.

". . .so, we've spent so much time trying to emphasize how much we are the same and trying to emphasize that we're equal and leaving aside the fact that there are some differences that are important and are special," says Dr. Toth. "Not a bad thing, but there it's important to figure out what those differences are and then, maybe the medications should be different."

The Duke University Medicine and Sports Center also specializes in programs for executives and senior athletes. Soon there will be a new program for alternative medicine. Dr. Alison Toth says she is encouraged by the university's "forward thinking."

"It's a wonderful thing to have a place like this that is so interested in bringing in new types of medicine and different approaches to things. And the same support I've found for my women's program just a little bit different there's been a lot of support and a lot of interest. And I think a lot of people deserve credit for that here at Duke to allow that to happen."

Dr. Alison Toth is an orthopedic surgeon and Director of the Duke University Women's Sports Medicine Program in Durham, North Carolina.