Creatine and Menopause: What the research actually says

Perimenopause and menopause come with a list of changes that nobody really prepares you for. Muscle loss. Fatigue. Brain fog. A body that feels like it’s working against you. And while the supplement industry has been quick to offer vague “women’s health” products that don’t do much, one supplement with serious research behind it has been quietly getting attention from scientists: creatine.

Here’s what we know, why it matters if you’re in your 40s or 50s, and where the evidence is still catching up.

What happens to your body during (peri)menopause?

As oestrogen levels decline, several things happen at once. A 2022 review in the International Journal of Women’s Health describes how women lose muscle mass more rapidly during this transition - a process called sarcopenia - partly because oestrogen plays a direct role in muscle protein turnover (Buckinx & Aubertin-Leheudre, 2022). Bone density can decrease, energy levels often drop, and cognitive symptoms like brain fog, memory lapses, and difficulty concentrating become more common.

These aren’t just inconveniences. Over time, muscle and bone loss in particular have real implications for long-term strength, independence, and quality of life, which is exactly why this deserves more than a vague “menopause support” label on a bottle.

Why the standard research doesn’t always apply to this life stage

Most of the foundational creatine research was conducted on young male athletes, which means a lot of the advice circulating online was never actually tested on women in midlife. A 2025 review in the Journal of the International Society of Sports Nutrition tracked creatine’s effects across a woman’s life stages, from menstruation through pregnancy to menopause, and found consistent support for strength, exercise performance, and cognitive function, while also noting that women remain under-represented in this research overall and that more targeted, long-term studies are needed (Smith-Ryan et al., 2025). We think that gap is worth naming rather than glossing over.

Where creatine comes in

On the muscle and bone side, a 2023 two-year randomised controlled trial in postmenopausal women, published in Medicine & Science in Sports & Exercise, combined creatine with resistance training and found improvements in some bone geometry measures at the hip, though it didn’t find a significant change in overall bone mineral density (Chilibeck et al., 2023). It’s a useful, honest reminder that creatine supports the strength training that helps protect bone health, it isn’t a standalone fix for bone density on its own.

The most exciting recent development is on the cognitive side. A small but well-designed 2025 randomised controlled trial, published in the Journal of the American Nutrition Association, followed 36 perimenopausal and menopausal women for eight weeks and found that creatine supplementation improved reaction time, increased brain creatine levels measured directly via imaging, and showed early signs of reducing the severity of mood swings, with no significant side effects reported (Korovljev et al., 2025). It’s worth noting this trial used low-to-moderate doses of creatine hydrochloride rather than the creatine monohydrate used in most other research (and in Two Islands Creatine Hydration) - promising, but still early days, and a good example of why we’d rather point you to the actual study than oversell it.

“What I love about the research coming out on creatine and menopause is that it’s finally specific to this life stage, rather than just borrowed from studies on young male athletes. It’s still early in places - the brain imaging study is small, for instance - but the direction of travel is really encouraging, and it’s exactly the kind of evidence-led conversation we want to be having with women in this stage of life, not vague promises.”

— Julia Matthews, Founder, Two Islands

Do you need to be exercising for creatine to work?

The muscle-related benefits are stronger when creatine is combined with resistance training - that’s consistent across the research above. But you don’t need to be lifting heavy weights. Regular walking, bodyweight movement, or light strength work is enough to see meaningful benefits when paired with creatine.

The cognitive and energy benefits, on the other hand, appeared in the 2025 trial regardless of exercise status, which makes creatine potentially useful even on rest days, or for women who aren’t currently doing structured training.

Creatine and protein: a combined strategy for midlife strength

Muscle preservation during and after menopause isn’t just about one supplement - it works best as part of a broader approach. Alongside creatine, adequate dietary protein spread across the day supports the same muscle-maintenance goal, particularly when paired with resistance or functional strength work like the yoga and gardening many women already enjoy. Neither replaces the other; creatine supports the energy your muscles use during effort, while protein supplies the building blocks for repair. Thinking of the two together, rather than reaching for a single “magic” ingredient, tends to be a more realistic and sustainable approach.

What about disrupted sleep and brain fog specifically?

Sleep disruption is one of the most common complaints during perimenopause, and it compounds the brain fog many women already notice. There’s an interesting, if early, connection here: a 2024 study in Scientific Reports found that a single high dose of creatine helped sustain normal brain energy levels and improved working memory and processing speed in sleep-deprived participants (Gordji-Nejad et al., 2024). It’s worth being precise about what this does and doesn’t tell us: the study used a much larger single dose than the 5g daily amount used in most other research (and in Creatine Hydration), and it looked at acute sleep deprivation in a lab setting rather than the chronic, disrupted sleep of perimenopause. It’s a genuinely interesting signal for why creatine’s brain-energy effects might matter most when you’re running on too little sleep, not a guarantee that daily supplementation will fix a rough night.

What about the water retention?

Creatine draws water into muscle cells, which can cause some initial bloating or a slight increase on the scales in the first week or two. This is normal and tends to settle; it’s also part of how creatine supports muscle health, not just a side effect to push through.

Staying well hydrated helps manage this, which is one of the reasons we’ve paired creatine with electrolytes in our Creatine Hydration formula. Electrolytes support fluid balance, which tends to make the first week or two more comfortable.

How much and how often?

3–5g per day is the standard, well-researched dose, and no loading phase is required - consistency over weeks is what matters. Most of the research above, including the postmenopausal bone and muscle trials, uses creatine monohydrate, which is what we use in Creatine Hydration at a 5g dose per serve.

A realistic daily routine

None of this needs to be complicated. A simple approach many women find sustainable: creatine with breakfast or your morning tea, a walk or a gentle strength session most days (even two or three sessions a week makes a difference), and protein spread reasonably evenly across meals rather than loaded into dinner. None of these are dramatic changes - they’re small, repeatable habits that, together with consistent creatine use, support the muscle, energy, and cognitive goals this life stage tends to bring into focus.

Is it safe alongside other midlife health considerations?

Safety is naturally front of mind at this stage of life, particularly if you’re already managing blood pressure, cholesterol, or bone health with your GP. The current evidence is reassuring: creatine’s safety profile, including for kidney function, has been assessed in a 2025 systematic review and meta-analysis in BMC Nephrology, which found no evidence of impaired kidney function in healthy adults using recommended doses. As always, it’s worth mentioning any new supplement to your GP, particularly if you’re on regular medication.

The bigger picture

Creatine isn’t a replacement for HRT or medical support if you need it, and it won’t address every symptom of perimenopause on its own. But the research on its benefits for women in midlife is compelling enough that it deserves a proper, honest conversation - one that’s often missing from women’s health spaces that lean on vague claims instead of actual studies.

If you’re in your 40s or 50s and looking for something backed by real science rather than marketing, creatine is worth discussing with your GP or naturopath, and worth trying alongside the movement and nutrition habits you’re probably already building into your week.

Frequently Asked Questions

Can I take creatine alongside HRT?

There’s no known interaction reported in the research above, but as with any supplement alongside hormone therapy, it’s worth checking with your GP or menopause specialist to confirm it’s right for your individual situation.

Does creatine help with hot flushes?

Not directly - the current research focuses on muscle, bone, cognition, and mood, not vasomotor symptoms like hot flushes. We’d rather be upfront about that than imply it does more than the evidence currently shows.

How long before I notice a difference?

Most of the research above used supplementation periods of 8 weeks to 2 years. Some people notice energy or training benefits within a few weeks, while cognitive and bone-related changes tend to take longer and are best assessed over months, not days.

Is creatine safe for someone my age if I have never taken a supplement like this before?

Creatine monohydrate has one of the largest safety databases of any supplement, spanning decades of research in a wide range of age groups. If you have an existing health condition or take regular medication, it’s still worth a quick conversation with your GP before starting, but there’s nothing about being a first-time supplement user in your 40s or 50s that changes creatine’s safety profile.

This article is for educational purposes only and does not constitute medical advice. Always consult your GP or a registered health professional before starting any new supplement, particularly if you are pregnant, breastfeeding, or managing an existing health condition.