Is creatine worth taking in perimenopause and after menopause?

The evidence for a benefit is in women who were also doing resistance training. Taken on its own, creatine showed no difference from placebo over one and two years on bone density, muscle mass or physical function in postmenopausal women.

• Two years of 3 g a day in 200 postmenopausal women with osteopenia: no difference from placebo on bone density, bone markers, lean mass, function, falls or fractures.
• Twelve months of creatine added to supervised resistance training slowed hip bone loss and raised upper-body strength compared with the same training plus placebo. Both groups trained, so the difference is what creatine added.
• Great Britain has two authorised creatine claims: one on repeated short bursts of high-intensity exercise, and one, for adults over 55, on the effect of resistance training on muscle strength. Each has conditions, and neither is a claim about menopause.

The short version

Creatine has become a fixture of midlife women's health writing. The trial evidence in postmenopausal women is narrower than that suggests, and it points somewhere specific: the benefit shows up when creatine is added to resistance training, and not when it is taken alone. There are no trials in perimenopause itself, so what follows is the nearest evidence, not direct evidence.

Taken on its own

Two hundred postmenopausal women with osteopenia were randomised to 3 grams of creatine monohydrate a day or placebo for two years. Bone density fell at the lumbar spine, femoral neck and total femur in both groups, with no difference between them. Bone markers did not differ. Lean mass and appendicular muscle mass rose in both groups over the study, again with no difference between creatine and placebo. Physical function, falls and fractures did not differ [1].

The authors concluded that the supplement alone does not have bone-building or muscle-building effects in this population over the long run.

A separate one-year trial at a lower dose, 1 gram a day in 109 older women, also found no difference from placebo on bone density, lean mass or muscle function [3].

Added to resistance training

The picture changes. Forty-seven postmenopausal women were randomised to a supervised resistance training programme three days a week with either creatine at 0.1 g per kg of body weight daily or placebo, for twelve months. Femoral neck bone density fell by 1.2 per cent in the creatine group against 3.9 per cent in the placebo group. The width of the femoral shaft, which relates to bending strength, increased with creatine and decreased with placebo. Relative bench press strength rose 64 per cent against 34 per cent [2].

Both groups trained. The comparison is therefore creatine added to training against training alone, and it favoured creatine. It does not say what training alone does; the trial was not designed to.

Two things temper it. Thirty-three of the forty-seven women completed the study, which is a small final sample. And the dose is higher than the 3 g in the authorised claim below: 0.1 g per kg is roughly 7 grams a day for a 70 kg woman.

What is authorised, and for whom

Great Britain has two authorised health claims for creatine, each with conditions set in the register [4]. One concerns physical performance in successive bursts of short-term, high-intensity exercise, at a daily intake of 3 g. The other, for adults over the age of 55, concerns the effect of regular resistance training on muscle strength, again at 3 g a day and in combination with that training.

Neither is a claim about menopause. The second is defined by age and by training, not by menopausal status, so it covers a woman over 55 who trains regularly whether or not she is postmenopausal, and it does not cover a woman in her forties. A product may carry either claim only in the form and under the conditions the register sets.

What is written above is a description of what the trials measured, which is a different kind of statement from an authorised claim.

Deciding

If you are not doing resistance training, these trials give no reason to expect a benefit on bone density, muscle mass or function from creatine on its own. If you are training, there is a reasonable case for adding it, and creatine monohydrate is the form that has been studied.

Creatine draws water into muscle, so a small rise in scale weight in the first weeks is expected and is not fat. In the two-year trial, laboratory safety measures were unchanged, and reported adverse effects were unremarkable [1]; that is a finding in those participants rather than universal safety advice, and anyone with kidney disease should ask a clinician first.

Where this leaves you

Creatine on its own is not supported by these trials. Creatine alongside regular resistance training has one twelve-month trial behind it, at a higher dose than is usually sold. HerStack does not recommend a product on this page: our published criteria use one reference brand, and where that range has no suitable product, as it currently does not for creatine, we say so rather than substitute another. The criteria are explained on our about page.

Published by: Suggestic Inc, herstack.co.uk. The HerStack editors. 2026-09-26. This page has not been reviewed by a clinician.