Do Perimenopausal Women Need to Take Creatine?

Creatine supplements have been everywhere lately, and while it’s often associated with athletes because of it’s role in supporting the growth of muscle mass, research is growing on how this supplement’s benefits can extend to women in perimenopause/menopause as well, particularly when combined with resistance training and a balanced diet.

What is Creatine and How Does It Work?

Creatine is a naturally occurring compound stored mostly in your muscles and brain. It helps regenerate ATP, the primary energy source for cells. While men typically have higher creatine stores, women’s stores decline with age and hormonal changes, making supplementation particularly relevant during menopause. 

Benefits for Menopausal and Postmenopausal Women

Muscle Strength & Lean Mass
Research shows that creatine, especially when combined with resistance training, improves muscle strength, lean mass, and physical function in postmenopausal women [1,2]. This is crucial because menopause accelerates age-related muscle loss, which affects metabolism, balance, and everyday function.

Bone Health
Evidence is mixed when it comes to bone health. Some long-term studies show no significant effect on bone mineral density (BMD), while others find improvements in bone geometry, but benefits appear to be strongest when creatine is paired with resistance training [3,4].

Cognitive and Mood Effects
Creatine may support memory, attention, and processing speed, and could help mood and energy, though evidence in menopausal women is still emerging [1,2].

Quality of Life & Physical Function
In women with knee osteoarthritis, creatine combined with exercise improved lower limb lean mass, physical function, and quality of life [5]. This shows that creatine can help women stay mobile, independent, and active, not just stronger.

Who May Benefit the Most

Creatine can be useful for women who are:

• Losing muscle or noticing strength declines.
• Doing or planning resistance training.
• Eating low amounts of animal protein (vegetarians or low-meat diets).
• Experiencing mild cognitive changes.
• Wanting to improve mobility and reduce fall risk.

Practical Tips for Supplementing

• Start low: If you’re prone to bloating, consider starting low at 1.5 g/day and then build up to 3 g/day. However, creatine is usually well tolerated!
• Take with food and hydrate to minimise GI upset.
• Pair with resistance training for best results.
• Dietary sources: Consider dietary sources as well including red meat, fish (salmon, herring, tuna), pork. These provide a natural source creatine! 

A Final Word

Creatine supplementation is generally safe and can help menopausal women by improving muscle strength, lean mass, functional mobility, and possibly cognitive function particularly when combined with resistance training.

It's less clear whether there are direct effects on bone mineral density and what the long-term effects on mood and cognitive outcomes is, and more research is needed in this area. All in all, creatine is a practical, well-studied supplement to support perimenopausal women’s health and can be valuable part of a lifestyle approach that includes exercise, nutrition, gut care, and rest.

References

1) Smith‐Ryan, A., DelBiondo, G., Brown, A., Kleiner, S., Tran, N., & Ellery, S. (2025). Creatine in women’s health: bridging the gap from menstruation through pregnancy to menopause. Journal of the International Society of Sports Nutrition, 22. https://doi.org/10.1080/15502783.2025.2502094.

2) Smith‐Ryan, A., Cabre, H., Eckerson, J., & Candow, D. (2021). Creatine Supplementation in Women’s Health: A Lifespan Perspective. Nutrients, 13. https://doi.org/10.3390/nu13030877.

3) Lobo, D., Tritto, A., Da Silva, L., Oliveira, P., Benatti, F., Roschel, H., Niess, B., Gualano, B., & Pereira, R. (2015). Effects of long-term low-dose dietary creatine supplementation in older women. Experimental Gerontology, 70, 97-104. https://doi.org/10.1016/j.exger.2015.07.012.

4) Chilibeck, P., Candow, D., Gordon, J., Duff, W., Mason, R., Shaw, K., Taylor-Gjevre, R., Nair, B., & Zello, G. (2023). A 2-yr Randomized Controlled Trial on Creatine Supplementation during Exercise for Postmenopausal Bone Health. Medicine and Science in Sports and Exercise, 55, 1750 - 1760. https://doi.org/10.1249/mss.0000000000003202.

5) Neves, M., Gualano, B., Roschel, H., Fuller, R., Benatti, F., Pinto, A., Lima, F., Pereira, R., Lancha, A., & Bonfa, E. (2011). Beneficial effect of creatine supplementation in knee osteoarthritis.. Medicine and science in sports and exercise, 43 8, 1538-43 . https://doi.org/10.1249/mss.0b013e3182118592.