Is creatine a beneficial diet strategy during menopause and peri-menopause? What the evidence says.
Many women notice changes in mood, cognitive function (memory, concentration) and muscle mass during perimenopause and menopause. Additionally, hormonal changes during the menopause transition (reduced oestrogen and progesterone) are known to have an impact on bone health (reduced bone density and increased risk of osteopenia and osteoporosis) and cardiovascular health risk (oestrogen helps regulate cholesterol levels and so falling oestrogen levels have an impact on lipid profile).
Creatine — an increasingly studied supplement for athletes — is now being investigated for menopause symptoms and clinical outcomes in mid-life women. Here’s what current research shows and what it means for you.
Before we start…
Peri-menopause and menopause are increasingly discussed, and some of this information can be daunting. This can be a challenging period for women - but that doesn’t mean its something to fear or that its all negatives and difficulties. There are a wealth of strategies to manage symptoms and help you take control - including nutrition and movement.
What is creatine?
Creatine is a naturally occurring compound stored mainly in muscle and also in the brain. It helps rapidly regenerate ATP (the body’s ‘energy currency’) — which is important for high-demand tissues like muscle and brain. Athletes have used creatine for decades; researchers are now testing whether it can reduce menopause-related declines in cognition, mood, and muscle (Smith-Ryan et al, 2021; Candow et al, 2023).
What changes with creatine during peri-menopause and menopause?
Hormonal changes and the consequences of these during peri-menopause and menopause mean that the body’s stores of creatine & demands for its use can change. Specifically, menopausal women can experience:
Reduced natural creatine production (Oestrogen supports the process involved in creatine production. When oestrogen drops in perimenopause/menopause, the body may produce less creatine - which can make energy production less efficient).
Reduced muscle stores of creatine (Peri-menopause and menopause can be associated with reduced muscle mass (although this is not inevitable!) - Creatine is stored mostly in muscle, so with less muscle mass you have lower storage capacity and faster depletion during activity. This results in increased fatigue, lower power output and slower recovery).
Changes in cognitive function/processing (Brain creatine helps maintain ATP used for memory, attention, and reaction time.
During menopause, many women report: brain fog, slower processing, more mental fatigue - increased brain creatine may help alleviate some of these symptoms)
How can creatine supplementation be beneficial for peri-menopausal and menopausal women? - The evidence.
What the new CONCRET-MENOPA trial found
A recent randomized, double-blind 8-week trial in 36 perimenopausal/menopausal women tested low-dose and medium-dose creatine hydrochloride (the medium-dose group took 1,500 mg/day group), a combination of creatine hydrochloride and creatine ethyl ester and compared to placebo. The medium-dose creatine HCl group (1500mg/day) showed the clearest benefits: a significant rise in frontal brain creatine levels, faster reaction times and favourable effects on lipid profile (cholesterol) compared with placebo. Benefits were also demonstrated in reducing mood swings and symptoms of low mood. The supplements were well tolerated and found to be safe - although this was a small study, over a limited duration (8 weeks). These results are encouraging because they show creatine actually reached the brain and produced measurable change (Korovljev et al, 2025).
What other studies show
Reviews and prior trials indicate creatine supplementation improves muscle strength and helps preserve lean mass in women, including those approaching or past menopause — especially when combined with resistance exercise. These physical benefits are relevant because menopause increases the risk of age-related muscle loss. There are also potential benefits demonstrated for reducing bone-loss in menopause, although these are less strongly evidenced at present (Smith-Ryan et al, 2021; Hall et al, 2025).
We know that creatine can improve sports performance and power output - which may help menopausal women to continue engagement in physical activity by reducing some fatigue and potential reduced performance which can be demotivating.
Evidence that creatine benefits cognition is mixed but biologically plausible: creatine can raise brain creatine stores and in some trials improves memory, processing speed, and mental fatigue — effects that could help with the “brain fog” many women report. Larger, targeted cognition trials in midlife women are still limited (Candow et al, 2023).
Safety and dosing
Most creatine research uses creatine monohydrate; the CONCRET-MENOPA trial used creatine hydrochloride at relatively low daily doses (e.g., 1,500 mg). Short-term safety in these trials appears good, but long-term safety data specifically in menopausal women is limited. People with kidney disease or taking certain medications should consult a clinician before starting creatine (Korovljev et al, 2025).
Overall, the evidence base is limited with most studies being small in size, with heterogeneous samples and limited duration. More evidence is needed - but the building body of current studies suggests creatine to be a beneficial tool in improving clinical outcomes and managing symptoms associated with menopause and peri-menopause.
In conclusion…
Creatine is promising for both brain and body in perimenopausal/menopausal women — particularly for reaction time, mood trends, and muscle/strength when paired with exercise (Smith-Ryan, 2021; Korovljev et al, 2025).
Creatine may also be beneficial for some clinical outcomes: lipid profile, bone health, mood.
Evidence is still preliminary: most trials are small or short. Larger, longer RCTs are needed to confirm who benefits most, ideal doses, and long-term safety.
Nutrition and physical activity are also key in managing menopause symptoms and outcomes - all of these things should be considered collectively.
What to consider before taking Creatine:
Do I have any kidney or health issues that may make creatine unsafe? (If so speak to a healthcare professional)
What dose and form of Creatine should I try? (Evidence on this is still limited - but consulting with a dietitian or nutritionist could offer some insights)
Should I combine creatine with diet changes or a resistance training plan for best results? - The answer is yes! Its worthwhile reaching out to specialists for support.
Overall
Creatine is cheap, well-researched in sports medicine, and now shows early promise for midlife brain and muscle health. If you’re curious, I’m happy to talk it through — enquire via rachel@rjperformancenutrition.com or the contact section on this website.
References & further reading
Korovljev D, Ostojic J, Panić J, et al. 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. J Am Nutr Assoc. 2025.
Smith-Ryan AE, et al. Creatine Supplementation in Women’s Health: A Lifespan Perspective. 2021.
Candow DG, et al. “Heads Up” for Creatine Supplementation and its Potential… Sports Med. 2023.
Hall L, et al. Impact of creatine supplementation on menopausal outcomes. 2025.