Creatine has traditionally been associated with gym-goers, athletes and muscle building. But interest in creatine for women is growing, particularly around perimenopause, menopause and healthy ageing
So, could creatine have a role during menopause?
The short answer is: possibly, particularly when combined with resistance exercise, but the research is still developing.
The evidence is most encouraging around muscle strength, lean mass and physical function in postmenopausal women, while research into bone health, cognition and other potential benefits is still developing.1,2 Evidence specifically in perimenopausal women remains limited.1
Why are researchers interested in creatine during menopause?
Creatine is a naturally occurring compound involved in the regeneration of adenosine triphosphate (ATP), the body's rapidly available energy source. Most of the body's creatine is stored in skeletal muscle, where it plays an important role in energy metabolism.1,2
The menopause transition is accompanied by physiological changes that can affect muscle, body composition and bone health, making the maintenance of muscle strength and physical function increasingly important.1
A 2025 review of creatine research in women's health identifies menopause as an important area of research. It suggests that creatine may have applications for muscle strength, exercise performance and body composition, particularly when combined with resistance training, while also highlighting the limited amount of research specifically involving perimenopausal women.1
Creatine and muscle strength
This is where the evidence is currently most encouraging.
Research in postmenopausal women suggests that creatine can complement resistance training. Rather than acting as a replacement for exercise, creatine appears to be most useful when incorporated alongside a programme that challenges the muscles.1,2
A two-year randomised controlled trial involving 237 postmenopausal women examined creatine supplementation alongside resistance training and walking. The study found no significant improvement in bone mineral density, but creatine supplementation helped maintain certain measures of proximal femur geometry. Among participants who completed the study, there was also a small additional increase in lean tissue mass, while walking performance improved.3
This distinction matters: creatine isn't simply a "muscle-building supplement". For women in midlife, maintaining the muscle needed for everyday activities, such as getting up from a chair, carrying shopping, climbing stairs and staying active, can be just as important as changing body composition.
The broader evidence reviewed in women's health research also suggests that creatine's effects on muscle strength and body composition may be particularly relevant when supplementation is combined with resistance training.1,2
What about bone health?
The answer is more complicated.
One earlier randomised controlled trial involving 47 postmenopausal women found that creatine combined with supervised resistance training attenuated the loss of femoral-neck bone mineral density over 12 months. The researchers also observed an increase in femoral shaft width, a measure associated with bone bending strength.4
However, the larger two-year trial did not find an improvement in bone mineral density at the femoral neck, total hip or lumbar spine. It did find improvements in some structural characteristics of the proximal femur, including measures associated with bone strength.3
So it would be premature to say that creatine prevents osteoporosis.
A more accurate interpretation is that creatine may support some aspects of musculoskeletal health, particularly when combined with resistance exercise, but its effects on bone mineral density remain inconsistent.1,3,4
Is creatine safe for women?
Current evidence is generally reassuring, although, as with any supplement, the evidence has limitations.
A systematic review and meta-analysis of female-only creatine studies included 951 participants across 29 studies that monitored adverse outcomes. The researchers found no deaths or serious adverse outcomes and no significant differences in overall adverse events, gastrointestinal events or weight gain. Measures of renal and hepatic function also showed no significant differences between creatine and control groups.5
Seven of the studies included in the review involved postmenopausal women.5
This does not mean that creatine is appropriate for everyone or that individual medical circumstances can be ignored. Anyone with an existing medical condition, taking medication or concerned about kidney health should discuss supplementation with their healthcare professional.
What about perimenopause?
This is one of the biggest unanswered questions.
Research specifically involving perimenopausal women remains limited.1
A 2026 randomised controlled trial investigated creatine hydrochloride, alone or combined with creatine ethyl ester, in 36 perimenopausal and menopausal women over eight weeks. The study found that a medium-dose creatine hydrochloride intervention improved reaction time and increased frontal brain creatine levels compared with placebo. The researchers also reported a potential effect on mood swings, although this finding did not reach conventional statistical significance.6
Importantly, this study used creatine hydrochloride and creatine ethyl ester rather than the creatine monohydrate used in much of the existing research, and it was relatively small and short-term. [6]
That means the results are interesting, but they should not be taken as proof that creatine improves menopause-related cognitive symptoms more broadly.
The 2025 women's-health review similarly identifies perimenopause as an area where direct clinical research remains limited.1
So, should women take creatine during menopause?
There isn't one answer for every woman.
What the research currently supports most clearly is the idea of creatine as an adjunct to resistance training, rather than a standalone menopause treatment.1,2
If you're interested in maintaining strength, lean mass and physical function as you age, resistance exercise, adequate protein, a balanced diet, sleep and overall physical activity remain important foundations. Creatine may be one additional tool worth discussing with a healthcare professional.
For women considering supplementation, creatine monohydrate is the form with the largest and longest-established research base.2
Creatine is becoming increasingly relevant to women’s health, with research exploring its potential role during perimenopause and menopause. Current evidence is particularly focused on muscle strength, lean mass and physical function, especially when creatine is combined with resistance training.1,2
For women looking to support strength, muscle health and healthy ageing during and after menopause, creatine may be a useful addition to an overall approach that includes regular resistance exercise, good nutrition and an active lifestyle
Related Health & Her resources:
Explore Health & Her Creatine+ and the Health & Her menopause supplement range.
References
- Smith-Ryan AE, DelBiondo GM, Brown AF, Kleiner SM, Tran NT, Ellery SJ. Creatine in women's health: bridging the gap from menstruation through pregnancy to menopause. Journal of the International Society of Sports Nutrition. 2025;22(1):2502094. doi:10.1080/15502783.2025.2502094.
- Smith-Ryan AE, Cabre HE, Eckerson JM, Candow DG. Creatine Supplementation in Women's Health: A Lifespan Perspective. Nutrients. 2021;13(3):877. doi:10.3390/nu13030877.
- Chilibeck PD, Candow DG, Gordon JJ, Duff WRD, Mason R, Shaw K, Taylor-Gjevre R, Nair B, Zello GA. A 2-yr Randomized Controlled Trial on Creatine Supplementation during Exercise for Postmenopausal Bone Health. Medicine & Science in Sports & Exercise. 2023;55(10):1750-1760. doi:10.1249/MSS.0000000000003202.
- Chilibeck PD, et al. Effects of Creatine and Resistance Training on Bone Health in Postmenopausal Women. Medicine & Science in Sports & Exercise. 2015;47(8):1587-1595. doi:10.1249/MSS.0000000000000571.
- de Guingand DL, Palmer KR, Snow RJ, Davies-Tuck ML, Ellery SJ. Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis. Nutrients. 2020;12(6):1780. doi:10.3390/nu12061780.
- Korovljev D, Ostojic J, Panic J, Ranisavljev M, Todorovic N, Nedeljkovic D, Kuzmanovic J, Vranes M, Stajer V, Ostojic SM. 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. 2026;45(3):199-210. doi:10.1080/27697061.2025.2551184.
