With billions of views for the hashtag #creatine on TikTok, the supplement is having a moment – and it shouldn’t come as a surprise. Previously the mainstay of bodybuilders and gym bros, creatine helps maintain the energy supply to your muscles, especially when they’re under strain. It also helps with increasing muscle growth and speeds up recovery.
But despite what you might think, creatine supplements aren’t just for gaining muscle mass. Its real function is building strong muscles and supporting longevity in later life. So naturally, it’s something that everyone could benefit from taking – especially women in midlife.
The words “muscle mass” might seem alarming to those who’d rather maintain the body they have, or who are looking to shed some weight, but creatine isn’t a supplement that bulks you up unless you’re specifically training to.
As we age, our muscle mass naturally decreases, particularly during perimenopause and menopause as hormone levels start to fluctuate. This is one of the symptoms of menopause, along with brain fog, trouble sleeping and a host of other irritating and debilitating issues.
Maintaining your muscle mass during this midlife period could make all the difference to how well you feel, how resilient your body is and how rapidly you experience the process of ageing.
Dr Lafina Diamandis, a GP, lifestyle medicine doctor and the founder of Deia Health, explains that “creatine helps to replenish intramuscular stores as well as improve the way our muscles use energy, which means greater muscle strength gains and protection against muscle loss as we age. This can be particularly beneficial in perimenopausal and menopausal women who commonly experience symptoms of fatigue and difficulty gaining muscle.”
“Women have 70 to 80 per cent lower baseline creatine levels than men, and these levels decline further as we age and with hormonal changes such as the menopause. Creatine is a well-researched supplement recommended for women in midlife, primarily to support muscle strength (and prevent muscle loss) and potentially to help with mood and cognitive health too,” she adds.
What is creatine?
Creatine is a chemical that, like many other supplements, is naturally found in the body. Its main responsibility is providing energy for muscles, so without it, you might feel weak or experience cramping. It works by increasing the body’s store of phosphocreatine – the molecule that helps produce adenosine triphosphate (ATP). ATP is the primary source of energy for your cells, particularly during short bursts of intense physical activity – which is why creatine has always been a favourite with weightlifters.
Luke Worthington, a personal trainer who specialises in preparing actors for film roles, says, “Creatine is the supplement I recommend the most frequently to my clients. It’s the most well-researched supplement in history, with thousands of published studies confirming its safety and effectiveness for improving strength and body composition, preserving muscle, enhancing performance and supporting brain health.
“Creatine occurs naturally in the body from amino acids and is stored mostly in muscle, where it helps regenerate ATP – the body’s most readily available energy source. We also get creatine from foods like red meat and fish, meaning supplementation is especially beneficial for people who eat little or no meat,” he adds.
Some wrongly assume that creatine is a steroid, partially due to its association with musclebound gymgoers. But, says Worthington, “creatine is safe and effective for all genders and all ages. It can be taken continuously without cycling and while it’s most beneficial when combined with progressive resistance training, it can also support energy metabolism and cognitive health regardless of exercise habits.”
What are the benefits of creatine for menopause?
As we age, our muscles and tissues will begin to weaken, recovery after exercise will become harder and we might be more prone to accidents as we lose our strength and our skeletons become less robust. For women, the onset of menopause means that oestrogen levels will drop and impact moisture levels in the body and muscle elasticity.
Studies have shown that creatine can help slow these processes down when combined with regular exercise, particularly strength training. Influencers like Liz Earle and Trinny Woodall are fans of creatine supplementation, citing the benefits for maintaining a strong body during menopause.
A 2021 paper suggested that creatine not only increases strength, fat-free mass, and muscle morphology but also “has the potential to be a multifactorial therapeutic intervention across the lifespan in females, with little to no side effects”.
According to Diamandis, “the research shows that supplementation, particularly when combined with regular resistance training can help to increase muscle strength. It can also help to increase muscle mass in older women, which is important in mitigating the risk of sarcopenia [low muscle mass] as it doubles the risk of osteoporosis. From a longevity perspective, health is muscle. Loss of muscle leads to frailty, increases the risk of falls and hip fractures, which in turn increase the risk of mortality.”
Creatine might also be used to tackle common menopause symptoms like brain fog – while 80 per cent of creatine is stored in your skeletal muscles, the other 20 per cent is stored in your brain. “Emerging evidence shows that it could potentially be useful as a tool for improving mood and cognition, and also fatigue-related symptoms linked to the menstrual cycle,” says Diamandis.
The combination of creatine with strength training could support longevity in several areas of the body (Getty/iStock)
Creatine and strength training: the magic duo
Experts have recommended various forms of strength training as a way to combat osteoporosis in midlife, particularly for women. Supplementing muscle health with creatine can help to make this type of training much more manageable. A 2023 study showed that using creatine with weightlifting results in greater muscle strength gains compared to strength training alone, particularly if strength training is sustained for at least six months.
“Creatine’s lean tissue-preserving benefits are most effective when combined with progressive resistance training. However, it can still support cognitive function, mood and overall cellular energy even in those who don’t exercise regularly. Even without exercise, creatine may help brain health, but for lean tissue and strength benefits, pairing it with suitable exercise is ideal,” says Worthington.
“Regular progressive resistance training helps mitigate the decline in oestrogen and growth hormone that accelerates in midlife, reducing the associated loss of muscle and bone. It’s the most effective way to improve body composition and it supports metabolic health by enhancing insulin sensitivity, which helps with weight management and reduces the risk of chronic disease.”
“Together, creatine and strength training work synergistically to preserve lean tissue, increase strength, improve mood and support cognitive and metabolic health, making the combination especially valuable during midlife. I describe it to clients as the training is planting the seeds and watering them, the creatine is adding some fertiliser!”
Studies have shown that creatine may help reduce inflammation, decrease soreness and prevent injury, which are all concerns that can crop up as women enter perimenopause and move into midlife. These issues can also hinder recovery, particularly if you are an active person or training for a specific purpose or goal.
In short, there are a lot of benefits to taking this supplement. Of course, it won’t be perfect for everyone and in some cases, creatine does encourage water retention in the body. It can also dehydrate you and withdrawal from it can make you feel fatigued.
“Another common misconception is that creatine can damage the kidneys, but this isn’t true,” Diamandis explains. “Creatine does not cause any clinically significant changes or long-term damage to kidney or liver function, though it can cause an increase in creatinine levels in kidney function tests.
“However, all supplements can cause side effects and creatine can cause dehydration, water retention, bloating and diarrhoea. It’s a good idea to go ‘low and slow’ when starting it for the first time and if you have any gut health-related medical conditions or take regular medications, it’s a good idea to check with your doctor before trying it,” she notes.
How to take creatine
Some people prefer to take creatine in capsule form, but if taking a lot of supplements doesn’t appeal to you, it might be preferable to add a scoop of creatine monohydrate to your coffee, tea or smoothie as part of your wellness routine. The powder is flavourless and generally unnoticeable. As with any supplement protocol, taking creatine requires consistency, so start with a small scoop or a tablet a day and track your progress as you go.
Worthington recommends a daily dose of 5g of creatine monohydrate. “This is effective and well-supported by research for all genders and ages. There is no evidence to suggest that higher doses produce better results and it doesn’t require a loading phase. Creatine can be taken at any time of day. Generally it would make sense to take it at the same time of day to maintain steady levels in the bloodstream, but consistency over time is what matters most. Tablet, capsule or powder – there is no real difference in effectiveness. It’s really a matter of personal preference and convenience.”
The easiest way to up your creatine is to eat foods that contain it and to add a scoop of creatine monohydrate powder to a drink. It’s a daily practice that could affect your health long term. However, it’s never too late to start. Whether we like it or not, we begin to lose muscle and bone volume as we age because of a natural drop in hormone levels, so whether you start building strength at 30 or 60, your body can still benefit from extra support.
“From around age 30, hormones like oestrogen and growth hormone decline gradually by about 1 to 2 per cent per year. However, during perimenopause and menopause, oestrogen levels can fall by as much as 10 to 20 per cent annually – accelerating loss of lean tissue, bone, and cellular regeneration. The good news is that strength training has been shown to slow, prevent and even reverse these declines. Creatine enhances strength-training effectiveness and aids preservation of lean tissue,” says Worthington.
Diamandis points out that, “you can start taking creatine at any time. Combined with strength training, it can help with muscle strength, exercise performance and body composition in premenopausal women so some like to take it as a preventative measure to mitigate muscle loss while others may have more specific performance-related goals.”
She adds that, “a recent review paper suggests that it could be a promising strategy for supporting various aspects of health, including cognition and mental health in women across the lifespan – though more research is needed to fully understand its potential, so watch this space. If you do try it, always track, test and measure the impact of any intervention on your symptoms.”