#014 - Creatine Isn’t Just for Gym Bros: Why Midlife Women Should Pay Attention

When you hear the word, “creatine,” do you picture big, beefy, dudes flexing their biceps in front of the gym mirror? I remember when creatine first became popular in the late 90’s/early 2000s. All of my muscly, athletic male friends were always talking about their creatine supplements and big gym gains. While I also did lots of weight training back then, it was clear that you needed to be in the “boys club” to use creatine. The marketing was clearly male-centric back then, not to mention we were still in the “waif era” where society pushed women to emulate runway models.

Fast-forward to 2025, and suddenly, creatine is back in the spotlight and showing up constantly in my feed, but now for my demographic: from menopause experts to female, midlife, wellness influencers, and even in the press. Now we are hearing that creatine isn’t just for muscle building and fitness performance, but also for wellness and cognition. If you’re like me, you might also be curious…should I take creatine? Is the hype legit? Does the evidence back the claims? Let’s dive in…

First, what is creatine & how does it work? (1,2)

Creatine is a naturally occurring compound derived from three amino acids. We produce creatine endogenously in our liver, kidneys, and to a lesser extent, pancreas. Dietary sources of creatine are primarily red meat and seafood. Creatine is a building block for adenosine triphosphate (ATP), which is colloquially called, “the body’s energy currency.” The mitochondria, aka. powerhouse, of our cells produce ATP. After consuming creatine, our muscles store it as phosphocreatine (PCr). During high-energy demands, PCr donates a phosphate group to adenosine diphosphate (ADP) to convert it to ATP. This process is especially crucial during short, intense bursts of activity like lifting weights, sprinting, or climbing stairs.

Once the muscle cells use the ATP to contract it is converted back into ADP. Without a way to quickly replenish ATP, energy output drops, fatigue sets in, and performance suffers. By supplementing with creatine, we increase the amount of PCr stored in muscle. The theory goes that over time, creatine enables us to train harder, lift heavier, or perform more reps before fatigue sets in. That repeated ability to push our muscles just a bit further triggers a greater adaptive response: increased muscle fiber recruitment, improved neuromuscular efficiency, and ultimately, greater strength and muscle mass.

Does creatine help women in midlife? (2)

Hormonal transitions during the peri- and postmenopausal periods have several adverse effects on women’s bodies. We will delve into the subject more deeply in the future, but for the purposes of this topic, declining estrogen leads to muscle loss (sarcopenia) and osteoporosis and dysregulates the brain’s energy use and neurotransmitters. While the effects of creatine for women in midlife is understudied, emerging research suggests that it has several advantages for both our bodies and minds.

A 2021 publication reviewed all the available literature on how creatine affects women across their lifespan (2). Focusing on the menopausal period, studies collectively suggest that creatine supplementation together with resistance training improves muscle growth, strength, and physical performance. It also appears to have favorable effects on bone when combined with resistance training. Creatine alone (without training) appears to offer only short-term or modest benefits.

Creatine also appears to have mental and cognitive benefits (2). Just like our muscles do, our brains also eat up ATP to function. This is especially true during periods of mental stress and during tasks that rely on the frontal cortex (cognition, attention, and memory). Evidence suggests that creatine supplementation improves cognitive performance and brain function and reduces mental fatigue. (I’m thinking brain fog fix, are you?) It also appears to be useful in augmenting mental capacity during periods of sleep deprivation. Given that sleep deprivation is a common occurrence in menopause, the case for creatine seems clear.

While creatine does appear to have benefits, the important caveat is that the evidence is still growing. What we are lacking in particular, is longitudinal data to show us how this affects long-term outcomes and longevity.

Should you use creatine? And how?

I think the case for creatine is pretty strong. Of all the supplements on the market, creatine is one of the most robustly studied. Decades worth of studies have demonstrated that it is safe and without side effects (2). The evidence is clear that it increases fat free mass and improves strength and exercise performance. Besides the cost of purchasing creatine, which is quite economical (8-15 GBP/month), I can think of little reason not to try it.

If you are ready to give it a go, your next question might be how to take it? What dose? How often? Pre- or post-workout?

When it comes to dose, most products recommend 3-5 g/day. However, the review on creatine use in women concluded that 5g/day is likely ideal for the menopausal phase of life. Creatine should be used daily, regardless of whether you will train that day or not. Loading doses don’t seem to confer any long-term benefits, so for the sake of ease, daily makes sense to me. Finally, it doesn’t seem to matter if you take the creatine pre- or post-workout. With daily dosing, you are ensuring that your creatine stores are always optimal so it doesn’t matter what time of day it is. Once you start, give it at least 2–4 weeks to notice physical or cognitive benefits—consistency is key.

Whether you're lifting weights, juggling life’s demands, or navigating the fog of fluctuating hormones, creatine offers a simple, evidence-based tool to support your strength, energy, and brain health. It’s not a magic powder—but in midlife, we’ll take every smart edge we can get.

By Dr. Kate Whitehouse, OB/GYN & Women's Health Expert

References:

1. Kreider RB, Kalman DS, Antonio J, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18. doi:10.1186/s12970-017-0173-z

2. Smith-Ryan AE, Cabre HE, Eckerson JM, Candow DG. Creatine Supplementation in Women's Health: A Lifespan Perspective. Nutrients. 2021 Mar 8;13(3):877. doi: 10.3390/nu13030877. PMID: 33800439; PMCID: PMC7998865.