Can creatine supplementation benefit peri / menopausal / post menopausal women?
Let’s take a look.
Creatine is a natural compound produced in the liver, kidneys, and pancreas from amino acids (the building blocks of protein) and is more abundant in foods such as meat and fish.
It is stored mainly in muscles to provide rapid energy during high-intensity exercise.
Creatine supplements have robust, human trial evidence for benefits in women’s strength and body composition and growing but still limited randomised evidence in menopausal women for muscle, bone geometry, and some functional and cognitive outcomes.
Evidence in women generally
Most creatine research historically included men, but several controlled trials and a recent 2025 women‑focused review suggest benefits in women as well.
Across these studies, creatine monohydrate consistently improves strength and lean mass when combined with resistance training and shows a good safety profile in healthy females.
Here are some key points from a 2025 narrative review on creatine in women’s health:
- Women respond to creatine with increases in relative strength and lean mass similar to men when dosing and training are comparable.
- Hormonal fluctuations (during the menstrual cycle, pregnancy, menopause) can influence normal creatine metabolism in the body, but there is no evidence that creatine supplementation is ineffective or harmful at standard doses because of these differences.
- N.B. In the UK, creatine is not recommended as a supplement to take during pregnancy however, there is discussion in research circles based off animal studies, that posit theoretical benefits for human pregnancy. Please note, the UK government does not recommend supplementing with creatine during pregnancy.
- No sex‑specific safety concerns were identified in available clinical trials; adverse events are typically mild gastrointestinal symptoms or water retention, as also seen in mixed‑sex studies.
- Creatine draws water to itself, and may influence water weight, and possibly scale weight, however, one meta-analyses showed no difference in weight from supplementation in females (de Guidland et al, 2020).
- A 2020 analysis of adverse outcomes in females taking oral creatine found no increased risk of serious events (including kidney dysfunction) at commonly used doses (this is a key phrase – commonly used doses) in otherwise healthy women, supporting its classification as a low‑risk supplement under appropriate medical oversight.
Postmenopausal women: bone, muscle, and function
The strongest data specific to menopausal women focuses on bone geometry (i.e. bone structure, shape, size and bone marrow thickness) and muscle strength, when creatine is combined with resistance training.
Long‑term bone health trials Two key trials in postmenopausal women have examined bone‑related outcomes:
- A 12‑month randomised, placebo‑controlled trial (creatine ≈ 0.1 g/kg/day, ~8–10 g/day) plus supervised whole‑body resistance training found that creatine preserved femoral neck bone mineral density (the bone of the upper thigh which inserts into the hip and increased femoral shaft width (the thickness of the upper-thigh bone), as a predictor of bone bending strength, compared with placebo training alone.
- A larger 2‑year randomised controlled trial (237 postmenopausal women, mean age 59 years) using creatine 0.14 g/kg/day during a combined resistance‑training and walking program did not show a significant group difference in femoral neck or lumbar spine bone mineral density but did show a greater proportion of women in the creatine group achieving meaningful improvements in hip geometric measures (cross‑sectional area, bone thickness and bone strength).
Taken together, these trials indicate that creatine does not reliably increase bone mineral density in postmenopausal women, but it can improve aspects of the upper-thigh bone geometry and help preserve the upper-thigh bone close to the insertion point of the hip when paired with long‑term resistance training.
My reading of this is the effects of creatine supplementation for postmenopausal women bone health are mild to moderate.
Creatine may be a useful adjunct to exercise‑based osteoporosis prevention strategies, rather than a stand‑alone bone drug in its own right.
Strength and body composition in menopausal women
A 2025 quasi‑experimental study followed 15 peri‑ and postmenopausal women over 14 weeks of twice‑weekly total‑body strength training with creatine monohydrate supplementation.
Creatine significantly increased lower‑body strength (isokinetic knee extensor peak torque – effectively a ‘knee extension exercise’) and was one of the only reported strength exercises which recorded a significant result across the group. There were no significant adverse changes in estradiol (a form of estrogen) or other clinical markers.
In this trial:
- Both peri‑ and postmenopausal women showed meaningful gains in lower‑body strength with creatine plus training.
- Perimenopausal women reported improved sleep quality, though the sample size was very small.
Cognitive and brain‑related outcomes in menopausal women
Evidence for cognitive or mood benefits specifically in peri‑ and postmenopausal women is new and still limited, but at least one recent randomized controlled trial addresses this question.
The CONCRET‑MENOPA trial (2025) randomised 36 perimenopausal and postmenopausal women (mean age ~50) to low‑dose creatine hydrochloride (750 mg/day), medium‑dose (1,500 mg/day), creatine hydrochloride plus creatine ethyl ester (800 mg/day), or placebo for 8 weeks.
The study assessed cognitive performance, clinical outcomes, brain creatine concentrations (via imaging), and biochemical markers.
Key findings from CONCRET‑MENOPA:
- Creatine supplementation produced measurable increases in brain creatine levels compared with placebo, confirming central uptake in perimenopausal and postmenopausal women at relatively low doses.
- Some cognitive measures (such as reaction time and aspects of attention or working memory) showed statistically significant improvements in one or more active creatine groups versus placebo, but effects were small meaning they may not have practical or meaningful real-life effects, and were not universal across all tests.
- No serious adverse events or clinically relevant negative changes in metabolic markers were reported over the 8‑week period.
Importantly, this is currently one of the only menopause‑specific RCTs on creatine and cognition, and it is modest in size and duration, so conclusions must remain cautious:
creatine can increase brain creatine and may confer small improvements in selected cognitive metrics in midlife women, but there is no strong evidence yet for large or durable effects on “brain fog” or mood during menopause.
When these menopause‑specific findings are viewed alongside adult mixed‑sex meta‑analyses (which show small but consistent benefits of creatine on memory, attention, and processing speed, particularly in individuals with lower baseline creatine or under stress conditions), they support a plausible, but still modest, role for creatine in cognitive support rather than a definitive treatment as the current research stands.
Safety and practical considerations in women and menopausal women
Safety data in females come from both dedicated female trials and larger mixed‑sex studies.
- A 2020 analysis of adverse outcomes in females taking oral creatine found no increased risk of serious events, including kidney dysfunction, at commonly used doses in otherwise healthy women.
- Trials in postmenopausal women using relatively high daily doses (~0.1–0.14 g/kg/day) for 12–24 months reported normal creatine clearance and no clinically meaningful differences in liver enzymes or other safety markers between creatine and placebo groups.
For practical use in women, including around menopause, the best‑studied form is creatine monohydrate at:
- A daily dose of 3–5 g without loading for long‑term use (most pragmatic and well tolerated), or
- A loading phase (e.g., ~20 g/day split into 4 doses for 5–7 days) followed by 3–5 g/day, if faster saturation is desired, as used in many performance studies.
In postmenopausal bone and strength trials, doses of ~8–10 g/day were used safely under supervision, but these are higher than typical over‑the‑counter use and are not necessarily applicable to most women doing general strength training.
A point to stress, these higher doses were used in this experiment under supervision.
Women with chronic kidney disease, significant cardiovascular disease, or taking a lot of other medications at the same time should discuss creatine with a clinician, as long‑term safety data in these specific high‑risk groups are more limited.
We currently do not have enough safety data in these groups.
For otherwise healthy peri‑ and postmenopausal women engaging in resistance or impact training, current evidence supports creatine as a safe, evidence‑based adjunct for improving strength and potentially supporting bone geometry and selected cognitive outcomes (i,e, specific aspects of cognitive performance such as memory), without strong proof yet for broad effects on mood or menopausal symptoms.
Research is emerging in this area, and recent studies in women may spur on more research and a better understanding and insight into the effects of creatine supplementation across a range of health domains and outcomes.
Want to read more about supplements? Have a read of my blog articles on:
Disclaimer:
No responsibility can be accepted for this article which does not constitute medical advice, and is for educational purposes only. You should always consult with a medical professional when deciding to take supplements and use them as directed, should you choose voluntarily to take them.
References:
Clegg, R. BBC (2025) Creatine – can this muscle-boosting supplement help sharpen my brain? Available at: https://www.bbc.co.uk/news/articles/c2lx7klzvpko (Access on 14th March 2026).
Chilibeck PD et al. (2015). ‘Effects of Creatine and Resistance Training on Bone Health in Postmenopausal Women’. Med Sci Sports Exerc. 47(8):1587-95. doi: 10.1249/MSS.0000000000000571. Available at: https://pubmed.ncbi.nlm.nih.gov/25386713/ (Accessed 14th March – no full article access. Behind a paywall).
Chilibeck PD, et al. (2023). ‘A 2-yr Randomized Controlled Trial on Creatine Supplementation during Exercise for Postmenopausal Bone Health’. Med Sci Sports Exerc. Oct 1;55(10):1750-1760. doi: 10.1249/MSS.0000000000003202. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10487398/ (Accessed on 14th March 2026 – currently full free article access).
Darren G. Candow, Scott C. Forbes, Emelie Vogt (2019). ‘Effect of pre-exercise and post-exercise creatine supplementation on bone mineral content and density in healthy aging adults’. Experimental Gerontology, Volume 119, Pages 89-92, ISSN 0531-5565, https://doi.org/10.1016/j.exger.2019.01.025. Available at: https://www.sciencedirect.com/science/article/pii/S0531556518307101 (Accessed on 14th March 2026 – no full article access. Behind a paywall).
de Guingand DL, Palmer KR, Snow RJ, Davies-Tuck ML, Ellery SJ. (2020). ‘Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis’. Nutrients. 15;12(6):1780. doi: 10.3390/nu12061780. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7353222/ (Accessed on 14th March 2026 – no full article access. Behind a paywall).
Hall, Lauren et al. (2025). ‘Impact of creatine supplementation on menopausal women’s body composition, cognition, estrogen, strength, and sleep.’ Journal of the International Society of Sports Nutrition vol. 22,Suppl 1 2533673. doi:10.1080/15502783.2025.2533673 Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12291186/ (Accessed on 14th March 2026 – no full article access. Behind a paywall).
Korovljev, D., et al (2025). ‘The Effects of 8-Week Creatine Hydrochloride and Creatine Ethyl Ester Supplementation on Cognition, Clinical Outcomes, and Brain Creatine Levels in Perimenopausal and Menopausal Women (CONCRET-MENOPA): A Randomized Controlled Trial’. Journal of the American Nutrition Association, 45(3), 199–210. https://doi.org/10.1080/27697061.2025.2551184 Available at: https://www.tandfonline.com/doi/full/10.1080/27697061.2025.2551184 (Accessed on 14th March 2026 – no full article access. Behind a paywall).
Smith-Ryan, A. E. et al. (2025) ‘Creatine in women’s health: bridging the gap from menstruation through pregnancy to menopause’, Journal of the International Society of Sports Nutrition, 22(1). doi: 10.1080/15502783.2025.2502094. Available at: https://www.tandfonline.com/doi/full/10.1080/15502783.2025.2502094#abstract (Accessed on 14th March 2026 – currently full free article access).
Xu C, Bi S, Zhang W, Luo L. (2024). ‘The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis’. Front Nutr. 12;11:1424972. doi: 10.3389/fnut.2024.1424972. Available at: https://pubmed.ncbi.nlm.nih.gov/39070254/ (Accessed on 14th March 2026 – no full article access. Behind a paywall).
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