Peer reviewed by Ali Anderson, RN, FNTP
Menopause is a major physiological shift—one that affects far more than hot flashes and mood swings. It brings changes in metabolism, body composition, bone density, cognitive clarity, and energy regulation. Yet despite its profound effects, most nutritional advice for women in midlife remains outdated or incomplete.
One supplement that’s starting to change that? Creatine. Long associated with bodybuilders and performance athletes, creatine is now being studied for its benefits in perimenopausal and postmenopausal women, and the results are promising.
From maintaining muscle mass to supporting brain health, here are three science-backed reasons why creatine deserves a spot in your menopause wellness routine.
1. Creatine Helps Preserve Muscle Mass and Strength
One of the most visible and frustrating changes during menopause is a loss of lean muscle, a condition called sarcopenia. Women lose up to 3–5% of muscle mass per decade after age 30, and this rate accelerates after menopause due to the drop in estrogen.
This loss isn’t just cosmetic. Less muscle means lower metabolism, higher body fat, and greater risk of insulin resistance, falls, and frailty later in life.
Why Creatine Helps
Creatine is stored in muscle cells where it helps produce adenosine triphosphate (ATP): the primary fuel for short bursts of activity like lifting weights or climbing stairs. Supplementation increases the availability of this fuel, improving muscle performance, recovery, and mass retention.
In a 2021 meta-analysis published in Nutrients, postmenopausal women who combined creatine supplementation (3–5g/day) with resistance training showed significantly greater improvements in muscle strength and lean mass than women who did resistance training alone.
“Muscle loss begins as early as the perimenopausal years and can accelerate after menopause due to declining estrogen levels,” says Ali Anderson, RN and FNTP Functional Nutritional Therapy Practitioner. “When paired with resistance training, creatine has consistently been shown in clinical studies to enhance muscle strength and help preserve lean body mass in women during midlife and beyond.”
2. It May Support Bone Density in a High-Risk Population
Loss of estrogen doesn’t just impact muscle—it also increases bone turnover, raising the risk of osteopenia and osteoporosis. Women can lose up to 20% of their bone density in the five to seven years after menopause, making proactive bone support critical.
How Creatine Plays a Role
Although creatine is not a calcium supplement, it supports muscle function and loading forces on bone, both of which are necessary to stimulate bone remodeling. Some studies suggest it may also affect bone cell signaling directly.
A clinical trial found that postmenopausal women who combined creatine with resistance training for 12 months experienced improvements in hip bone mineral density, especially in those who were new to strength training.
In another study, creatine helped preserve muscle and bone mass in women over 50 undergoing a resistance program—particularly in the femoral neck, a key fracture site in osteoporosis.
“Bone loss and muscle loss go hand in hand,” Anderson notes. “Creatine helps keep both systems strong, which is why I often recommend it for women over 45.”
3. Creatine Supports Cognitive Function and Mental Energy
Brain fog. Forgetting words. Slower recall. Many women experience these symptoms during the menopausal transition, sometimes chalked up to aging or stress. But hormone changes—especially the drop in estrogen and progesterone—can directly impact neurotransmitters, memory pathways, and sleep quality.
Why Brain Cells Need Creatine
The brain consumes 20% of the body’s energy, and it relies on creatine to recycle ATP efficiently. Low brain creatine has been linked to mental fatigue, poor memory, and slower cognitive processing.
A 2024 review noted that creatine supplementation improves short-term memory, processing speed, and task-switching ability, especially under conditions of mental stress or sleep deprivation.
This matters for menopausal women, many of whom struggle with cognitive changes that aren’t addressed by conventional hormone therapy alone.
In a double-blind trial, women who supplemented with 5g/day of creatine performed significantly better on complex working memory tasks after just 6 weeks.
“Cognitive symptoms during menopause are real and often under-discussed,” says Anderson. “Creatine isn’t a magic fix, but it helps stabilize brain energy metabolism—which is foundational to clear thinking.”
Other Potential Benefits Worth Noting
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Mood support: Some early studies suggest creatine may help reduce depressive symptoms, particularly in women when combined with SSRI treatment
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Better blood sugar control: Creatine may improve glucose transporter activity, which helps regulate insulin sensitivity, particularly when combined with exercise
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Enhanced recovery from exercise: It can reduce post-exercise soreness and improve recovery time, allowing for more consistent movement
How to Add Creatine to Your Routine
Choose the Right Form
Stick with creatine monohydrate—it’s the most researched, cost-effective, and proven form. There’s no need to pay more for newer versions unless recommended by a healthcare professional.
Look for a product that’s:
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Third-party tested for purity (like NSF or Informed Sport certified)
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Micronized, if you want it to mix more easily into liquids
How Much to Take
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Standard maintenance dose: 3–5 grams per day
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Optional loading phase: 20 grams per day (split into 4 doses) for 5–7 days, then drop to 5 grams/day
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No need to cycle off: Creatine doesn’t downregulate your natural production
Best Time to Take It
While timing isn’t critical, creatine may be slightly more effective when taken post-workout with carbs or protein, which can enhance uptake into muscles.
For non-exercisers, taking it at any consistent time—preferably with a meal—is fine.
Looking for the best recipes for creatine? We've broken down the best with in-season fruits and veggies.
Safety and Side Effects
Creatine is widely regarded as safe, with over 1,000 studies supporting its use in various populations, including older adults. Common myths—that it causes kidney damage, dehydration, or weight gain—have been disproven in healthy individuals.
Mild side effects may include:
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Temporary water retention during loading phase
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Minor bloating or stomach upset in some individuals, especially during higher-dose loading phases (If you're new to creatine, consider starting with a lower dose—such as 1 to 2 grams per day—for the first week to allow your digestive system to adjust.)
Still, always consult with your healthcare provider if you have chronic kidney issues or are on medication.
Final Thoughts
Creatine is no longer just a supplement for bodybuilders. It’s a well-researched, low-risk, and affordable way to support muscle health, brain function, and bone density—three critical areas of concern during and after menopause.
If you're navigating this transition and looking for ways to stay strong, focused, and mobile, creatine could be a smart, science-backed addition to your routine.
“Creatine is one of the most underrated tools in women’s health,” Anderson says. “For less than a dollar a day, you get benefits for your muscles, bones, and brain. That’s a worthwhile investment at any stage of life.”
