Creatine and Perimenopause: What the Research Says for Women

You May Have Heard Creatine Is Just for Bodybuilders

For decades, creatine was associated almost exclusively with men lifting heavy weights and trying to get bigger. If you pictured it at all, you probably pictured something for a different demographic entirely.

That picture is changing. Researchers studying creatine in perimenopausal and postmenopausal women have found results interesting enough to shift how some sports medicine and women's health experts think about this supplement. The conversation is still evolving, but it is no longer a fringe one.

Here is what the current evidence actually shows, and what it still doesn't.

What Creatine Is and What It Does in Your Body

Creatine is a compound made naturally in your liver and kidneys from amino acids. You also get it from animal foods, particularly red meat and fish. Your body stores most of it in muscle tissue, where it functions as a rapid energy source for short bursts of intense activity.

When you take creatine as a supplement, you increase the amount stored in your muscles. This is well-established. The additional creatine allows muscles to regenerate energy faster during exercise, which translates to being able to do a bit more work before fatigue sets in. Over time, that extra capacity supports greater training adaptation.

Creatine is one of the most extensively studied sports supplements in existence. Its safety in healthy adults at commonly researched doses is supported by a large body of evidence spanning decades.

What the Research Suggests for Perimenopausal Women

Studies examining creatine specifically in perimenopausal and postmenopausal women are growing in number, though the field is younger than creatine research in men. Several findings stand out.

Muscle mass and strength: Some research suggests that creatine supplementation combined with resistance training produces greater gains in muscle mass and strength in older women compared to resistance training alone. For perimenopausal women, who are losing muscle more rapidly due to declining estrogen, this is potentially significant.

Bone health: A few studies have examined creatine and bone mineral density in older women doing resistance training. Some have found modest benefits, though the evidence here is more preliminary. Researchers believe the mechanism may involve creatine's role in energy production within bone cells rather than a direct hormonal effect.

Cognitive function: This is a newer area of research. Some studies have examined creatine and cognitive performance, including working memory and mental fatigue. A 2022 study in older adults found measurable improvements in cognitive tasks. Whether this translates specifically to the brain fog many perimenopausal women experience has not been studied directly, but the mechanism is plausible given creatine's role in brain energy metabolism.

What the Research Does Not Show

It's important to be clear about what creatine does not do. It is not a hormone. It does not interact with estrogen receptors. It does not replace hormone therapy or address the root hormonal causes of perimenopause symptoms.

Most research showing meaningful benefits involves creatine used alongside resistance training, not as a standalone supplement taken without exercise. The strength and muscle benefits appear to come from creatine allowing more productive training, not from the supplement alone doing something to muscle independently.

Creatine causes water retention in muscle tissue. This is a normal part of how it works, and it is not the same as body fat gain. But it does mean you may notice a small increase on the scale when you start using it, and some women find this uncomfortable to navigate during perimenopause when body composition is already a source of stress. Knowing this in advance helps it be less alarming.

Practical Considerations

Studies have commonly examined doses of 3-5 grams of creatine monohydrate daily in women. Creatine monohydrate is the most researched form and is typically the most affordable. There is no strong evidence that more expensive alternatives like creatine HCL or creatine ethyl ester outperform monohydrate.

Talk to your healthcare provider about the right dose for your situation before starting.

Creatine does not need to be taken at any specific time of day in most research. Some people experience mild stomach discomfort if they take it on an empty stomach. Taking it with food or with a post-workout meal works fine for most people.

You may have seen references to a loading phase, where a larger amount is taken for the first week to saturate muscle stores quickly. Loading is optional. Taking a standard dose daily reaches the same saturation point after about a month. The loading approach is faster but not necessary.

Getting Started

If you want to try creatine, a reasonable starting point is a conversation with your healthcare provider first, particularly if you have kidney disease or are on medications that affect kidney function. Creatine is processed by the kidneys, and while it is safe for healthy kidneys at studied doses, it is not appropriate for everyone.

Start with a single daily serving mixed into water, a smoothie, or another beverage. Creatine monohydrate has a very mild flavor and mixes easily. Give it at least four to six weeks of consistent use alongside regular resistance training before drawing conclusions about whether it is doing anything for you.

Buy from a brand that uses third-party testing for purity and label accuracy. Certifications like NSF Certified for Sport or Informed Sport provide this assurance.

What to Watch Out For

Staying well hydrated is important when using creatine, since it draws water into muscle cells. This is especially worth noting for women who already deal with hot flashes and the increased fluid losses they can cause.

Gastrointestinal discomfort is the most commonly reported side effect, usually manageable by taking creatine with food rather than alone. If you experience ongoing discomfort, a lower dose or a different form may help.

If you have a history of kidney problems, are pregnant, or are breastfeeding, creatine supplementation is a conversation for your doctor, not a general recommendation.

Track Your Progress

Creatine's effects during perimenopause are modest at the population level, but your individual response will vary. The best way to know whether it is making a difference for you is to track what's happening over time.

PeriPlan lets you log workouts and track patterns across weeks and months, so you can see how your strength and energy are moving rather than relying on day-to-day impressions that are easy to distort when symptoms fluctuate. Log a baseline before starting and give it consistent time before evaluating.

When to Check With Your Doctor