Should women use creatine during perimenopause?

If you usually think of creatine as a sports supplement, seeing it mentioned alongside perimenopause may be surprising. Still, women may benefit from it as well, and new research suggests its possible advantages may reach beyond exercise performance. That has made creatine an increasingly interesting supplement during perimenopause, a life stage that has long been underexplored and underserved.

Studies focused specifically on creatine during perimenopause remain limited. Most of the evidence comes from broader creatine research, plus studies involving older and postmenopausal women. Even so, there is enough data to begin connecting some of the dots, especially around muscle and strength, with early but intriguing findings in other areas relevant to the menopause transition. Here’s what is known so far.

Key takeaways

• Muscle mass and strength naturally decline with age, and hormonal shifts during the menopause transition may speed that loss.
• Creatine can help improve strength and lean mass, especially when used with resistance training.
• Research specific to perimenopause is still limited, but studies in older and postmenopausal women offer clues about how creatine may support women at this stage of life.
• A recent meta-analysis found that creatine taken with resistance training improved leg strength and lean mass in postmenopausal women.
• Researchers are also studying creatine’s possible effects on bone health and cognition, though the evidence is still developing.
• The standard evidence-based dose is 3–5 grams of creatine monohydrate per day; for muscle and strength goals, pair it with resistance training.

What creatine is and how it works

Creatine is a compound the body makes and also gets from food. Most of it is stored in the muscles, where it helps provide energy during short, intense efforts.

Muscles rely on a molecule called adenosine triphosphate, or ATP, for energy, but only a small amount is available at once. When those reserves start to run low, stored creatine in the form of phosphocreatine helps rapidly replenish them. With more phosphocreatine on hand, muscles may be able to squeeze out another rep or keep going for a few more seconds before tiring. Over time, that can help improve training results.

The body turns over about 2 grams of creatine each day. The liver and kidneys make about half of what is needed, while the rest usually comes from the diet, mainly from animal foods. But intake varies widely. Research shows that women consume 30%–40% less dietary creatine than men, intake tends to fall with age, and people who eat little or no animal protein get very little creatine from food. As a result, some people may begin with lower creatine stores than others.

Even a typical omnivorous diet does not fully saturate muscle creatine stores. Levels generally sit at about 60%–80% of capacity, and supplementation can increase muscle creatine and phosphocreatine by 20%–40%, giving muscles more to draw from when energy demand rises.

Why is creatine getting attention during perimenopause?

To understand the interest in creatine during perimenopause, it helps to look at where its possible benefits overlap with the changes that happen during this stage of life.

Perimenopause is the years-long transition around menopause, when changing hormone levels can affect the whole body. During this time, age-related loss of muscle mass and strength may speed up. Bone loss can also accelerate in late perimenopause, and cognitive symptoms such as brain fog and trouble concentrating are common. These changes overlap with areas where creatine has drawn scientific interest. Its effects on muscle and strength are already well established, and early research is exploring possible benefits for both bone and cognitive health.

There are important limits to the evidence, however. Research on creatine’s potential benefits beyond exercise performance is still emerging. Women have also historically been underrepresented in creatine studies; one review from 2020 found that only about 9% of creatine supplementation studies were conducted exclusively in women. Research specifically involving perimenopausal women is even thinner, and the few studies that include them often group them with postmenopausal women.

What benefits might creatine offer during perimenopause?

Although research during the menopause transition is still developing, the evidence points to a few possible areas of benefit. The strongest support is for muscle and strength, while the evidence for bone and cognition is more preliminary.

Creatine, muscle, and strength during perimenopause

One of creatine’s best-established effects is improved high-intensity exercise performance. Over time, when it is combined with resistance training, that can lead to greater gains in strength and lean mass, which is mostly muscle. Research suggests these benefits apply to women as well as men.

That may matter especially during the menopause transition. Muscle mass and strength decline with age in everyone, but hormonal changes during perimenopause appear to speed up that loss. By one estimate, women lose about 1.5 pounds of lean mass each year during the transition. Preserving muscle and strength becomes increasingly important, which helps explain the growing interest in creatine.

Creatine’s effects on muscle and strength have not been studied specifically in perimenopausal women. Still, evidence in older women suggests it can help support strength and lean mass. A recent meta-analysis of trials in postmenopausal women found that creatine increased leg-press strength by 7.5 kg and lean mass by 0.37 kg compared with placebo.

Another meta-analysis found that creatine combined with resistance training improved upper-body strength in older women, with gains in both upper- and lower-body strength in studies lasting at least 24 weeks. A trial in adults ages 45 to 65, more than half of whom were women, found that 12 weeks of creatine at 10 grams per day increased lean tissue mass and strength compared with placebo, including among people who were not following an exercise program. The evidence has not been fully consistent, though: a two-year trial of 237 postmenopausal women found no added strength benefit from creatine on top of resistance training.

Overall, these findings suggest creatine may be a useful tool for supporting muscle and strength as women move through the menopause transition, though more research in perimenopausal women is still needed.

Creatine and bone health during perimenopause

Bone loss speeds up during the menopause transition. There is relatively little change in early perimenopause, then the pace increases in late perimenopause—about 1.6% per year at the spine and 1% at the hip—and continues at a similar rate through the early years after menopause.

Researchers think creatine could potentially help support bone health, but that has not been proven. One theory builds on creatine’s effects on muscle: stronger muscles place more force on bone, which may stimulate bone remodeling, the process of breaking down old bone and building new bone. Researchers have also suggested that creatine may act directly on cells involved in building and maintaining bone.

So far, clinical studies have shown mixed results. In a small 12-month trial of 47 postmenopausal women, those taking creatine while resistance training lost less bone density at the femoral neck than those using placebo. A larger two-year trial of 237 postmenopausal women found no benefit for bone mineral density, though it did show improvements in some measures linked to bone structure and strength. A recent meta-analysis also found no overall benefit for bone mineral density.

In general, the research has not consistently shown that creatine improves bone mineral density. However, some evidence suggests it may help preserve bone at certain sites or influence aspects of bone structure and strength that are not captured by bone density alone. Whether those effects matter during perimenopause still needs to be studied.

Creatine and cognition during perimenopause

Many women experience cognitive changes during the menopause transition, including brain fog, word-finding trouble, and difficulty concentrating. The brain, like muscle, needs a steady energy supply to function, and creatine helps rapidly regenerate that energy in the form of ATP.

Research is still early, but there are signs creatine may support some aspects of cognition. A 2023 meta-analysis of eight small trials found that creatine improved memory measures compared with placebo, with the clearest benefit in adults ages 66 to 76 and no benefit in younger people ages 11 to 31. The older-adult finding was based on only two studies, so the researchers urged caution in interpreting the results. The age range most relevant to perimenopause was not included, but the findings raise the possibility that creatine could support memory health earlier in the aging process as well.

Creatine may also help when the brain is under stress. In one small trial, a single high dose reduced declines in memory and processing speed after 21 hours without sleep; another study found that a lower single dose also reduced declines on several cognitive tasks during sleep deprivation. Since sleep disruption is common during perimenopause, these findings may be especially interesting for women in this life stage. However, both studies used doses much higher than the standard daily amount and were not conducted specifically in perimenopausal women, so it is unclear whether 3–5 grams a day would have the same effect.

Research directly examining creatine and cognition in women around the menopause transition is even more limited. In one small eight-week trial of 36 peri- and postmenopausal women, low doses of non-monohydrate creatine forms increased brain creatine levels and improved response speed on some cognitive tests compared with placebo.

While more research is needed, these early findings suggest creatine could potentially support cognitive function during perimenopause.

How to take creatine during perimenopause

There is no perimenopause-specific creatine protocol, but research supports a few practical guidelines:

Dose

The standard evidence-based dose is 3–5 grams of creatine monohydrate per day. Research in older postmenopausal women found benefits for strength and lean mass with at least 5 grams per day when combined with resistance training.

Some people use a higher-dose loading phase of 20 grams per day for 5–7 days to saturate muscle stores more quickly, but it is not required. A regular daily dose reaches the same point in about three to four weeks, and skipping the loading phase can help avoid the small, temporary increase in water weight that sometimes comes with it.

Form

Choose creatine monohydrate. It is the most thoroughly researched form.

Timing

Research has not identified the best time of day to take creatine. Because it works by gradually increasing muscle creatine stores over time, consistency matters more than timing.

Training

If your goal is to build or maintain muscle and strength, pair creatine with resistance training. Research shows the combination can support greater gains in both, including in older women.

Is creatine safe for women in midlife?

Creatine monohydrate is one of the most well-studied supplements available, and at recommended doses it appears safe for healthy adults, including in studies lasting up to five years.

In a systematic review of 29 trials in women, researchers found no serious adverse events and no significant differences in body weight, kidney markers, or liver markers compared with placebo. Reported side effects are usually minor, including occasional stomach discomfort, which is more common with larger single doses.

Talk with a healthcare provider before starting creatine if you have kidney disease or reduced kidney function. Creatine can raise creatinine, a marker used in kidney testing, which can make results harder to interpret. If you are pregnant or breastfeeding, you should also check with your provider first, since human research on creatine during pregnancy is still limited.

Where creatine may fit in perimenopause care

If preserving or building muscle and strength is a priority during perimenopause, creatine may be worth considering, especially alongside resistance training. Its benefits for strength and high-intensity exercise performance are well established, and research in older women suggests it can support gains in strength and lean mass.

Possible benefits for cognition and bone health are also intriguing, particularly in the broader context of healthy aging. Early research suggests creatine may offer advantages beyond muscle and strength, though more work is needed to understand what role those benefits might play specifically during perimenopause.

For healthy adults, creatine is considered safe at recommended doses. If you choose to add it to your routine, the standard evidence-based dose is 3–5 grams of creatine monohydrate daily. And if muscle and strength are your main goals, pair it with resistance training, since that combination has been shown to help both in the general population and in older women.

FAQs

Is creatine good for perimenopause?

Creatine may help support muscle and strength during perimenopause, especially when combined with resistance training, although that evidence comes from studies in older and postmenopausal women rather than perimenopausal women specifically. Researchers are also exploring possible benefits for bone health and cognition, but that work is still emerging.

How much creatine should a woman in perimenopause take?

There is no perimenopause-specific dose, but 3–5 grams of creatine monohydrate per day is the standard evidence-based amount for adults. In postmenopausal studies that found benefits for strength and lean mass, participants took at least 5 grams per day along with resistance training.

Does creatine help with perimenopause brain fog?

It is not yet clear. Early research on creatine and cognition is promising. In one small eight-week trial of 36 peri- and postmenopausal women, low doses of creatine improved response speed on some cognitive tests and increased brain creatine levels compared with placebo. Other research in broader groups has found possible benefits for memory and cognitive performance, but more study is needed to know whether that translates to relief from perimenopausal cognitive symptoms.

Does creatine help bone density during perimenopause?

Creatine has not been studied for bone density specifically during perimenopause, and findings in postmenopausal women have been mixed. One study found less bone loss at the femoral neck, but a recent meta-analysis found no overall benefit for bone mineral density. Some studies have shown possible benefits for other measures of bone strength and structure, but more research is needed to understand their significance. If you are concerned about bone density during perimenopause, talk with your healthcare provider.

Will creatine cause weight gain during perimenopause?

Creatine has not been shown to increase body fat. During a loading phase, some people may notice a small, temporary rise in body weight as water moves into the muscles, though this does not happen to everyone. Studies in women specifically have not found a significant change in body weight.

Can I take creatine with hormone therapy?

There is not enough research to know whether hormone therapy changes creatine’s effects. The trial in peri- and postmenopausal women excluded women using hormone therapy, so it cannot tell us how the two might interact. If you use hormone therapy, speak with your healthcare provider before adding creatine.