Creatine in Perimenopause: Benefits, Safety, and How to Use It
Creatine is one of the most researched supplements for muscle, energy, and brain health. Here is what perimenopausal women need to know about using it.
What Creatine Is and How It Works
Creatine is a naturally occurring compound made from amino acids in the liver and kidneys, and also obtained from meat and fish in the diet. It is stored predominantly in muscle tissue, where it plays a key role in regenerating adenosine triphosphate (ATP), the primary energy currency of cells. When muscles perform intense short bursts of activity, ATP is used up rapidly, and the phosphocreatine stored in muscle replenishes it quickly. This is why creatine has been studied extensively for strength, power, and high-intensity exercise performance. Over the last decade, research has also expanded into creatine's effects on the brain, bone, and hormonal health, making it increasingly relevant for perimenopausal women.
Creatine and Muscle Mass in Perimenopause
Muscle loss (sarcopenia) accelerates during perimenopause, driven in part by declining oestrogen and the anabolic role it plays in muscle protein synthesis. Maintaining muscle mass matters enormously for metabolic health, strength, injury prevention, and long-term independence. Creatine supplementation, when combined with resistance training, consistently improves muscle strength and lean mass gains compared to training alone. For perimenopausal women who are already doing or starting strength work, adding creatine is one of the most evidence-backed strategies available. Even women who are newer to resistance training see meaningful benefit, which makes it accessible regardless of starting fitness level.
Creatine and Bone Health
Some research suggests that creatine may support bone health by increasing the workload muscle puts on bone during exercise, which stimulates bone remodelling. Studies in postmenopausal women have found that creatine supplementation combined with resistance training leads to greater improvements in bone mineral density compared to training without creatine. The mechanism is thought to involve creatine's role in supporting the energy-intensive process of bone formation. While the evidence is still developing, bone density is a major concern in perimenopause, and creatine's potential contribution to bone health adds another reason to consider it alongside a strength training programme.
Creatine and Brain Health
The brain uses large amounts of energy and contains its own creatine stores, which support cognitive function under demanding conditions. Emerging research has found that creatine supplementation may improve memory, processing speed, and mental fatigue, particularly in situations where brain creatine is depleted. Older adults, vegetarians, and women appear to show the greatest cognitive response to creatine supplementation, possibly because their baseline brain creatine levels are lower. During perimenopause, when brain fog and memory lapses are common complaints, this is a compelling line of research, even if more large-scale trials specifically in perimenopausal women are still needed.
Does Creatine Cause Bloating or Weight Gain
A common concern about creatine is that it causes unwanted weight gain or bloating. The initial weight increase that can occur at the start of supplementation is water retention within muscle cells, not fat gain. Muscles draw water in alongside creatine, which is why some women notice the scale move slightly upward in the first week or two. This effect is more pronounced with loading protocols (taking 20 grams per day for five to seven days) and is reduced or eliminated with the standard maintenance approach of 3 to 5 grams per day from the start. The water retained within muscle is generally not noticeable in the way that subcutaneous water retention is, and many women report no visible change in their appearance.
How to Take Creatine
Creatine monohydrate is the form with the most research behind it and is also the most affordable. Other forms such as creatine HCl and buffered creatine are marketed as superior but have less evidence and cost more. A daily dose of 3 to 5 grams of creatine monohydrate is the standard recommendation, taken consistently each day. Timing matters less than often suggested; taking it at any point in the day is effective, though some research suggests post-workout may have a slight advantage. It can be added to water, juice, a protein shake, or any other drink. Creatine has a very strong safety record across decades of research and is not associated with kidney damage in healthy people at standard doses.
Who Should Avoid Creatine and When to Seek Advice
Creatine is safe for the vast majority of healthy adults. People with pre-existing kidney disease or a single kidney should consult their GP before supplementing, as the kidneys process creatine and higher loads could be problematic in impaired kidney function. Creatine is not a banned substance and is approved by all major sporting bodies. If you are taking any prescription medications, it is sensible to mention creatine use to your GP or pharmacist, though interactions are rare. Given its evidence base for muscle, bone, and potentially cognitive health, creatine is one of the supplements most worth discussing with a healthcare provider during perimenopause if you are considering a supplementation strategy.
Related reading
Get your personalized daily plan
Track symptoms, match workouts to your day type, and build a routine that adapts with you through every phase of perimenopause.