Creatine and Menopause: What Changes and What Helps

Why talk about creatine and menopause now?

Creatine is getting a lot of attention in women's health. Researchers now study it across a woman's whole life, from menstruation through pregnancy to menopause [2].

The starting point is strong. The International Society of Sports Nutrition concluded that "creatine monohydrate is the most effective ergogenic nutritional supplement currently available to athletes" (ergogenic means performance enhancing) for increasing high intensity exercise capacity and lean body mass during training [3].

So why menopause? Muscle and bone both change faster in the years around the final period [4][5].

What changes in your body around menopause?

Bone changes fastest. In the US SWAN study of 862 women, the lower spine lost 10.6% of its density over 10 years, with 7.38% of that loss in the 3 years around the final period [5].

Hormones and age both play a part. Oestrogen deficiency after menopause is a major cause of osteoporosis (thin, fragile bones) [8]. Some loss of spongy inner bone begins as early as young adulthood [9].

Muscle and fat shift too. In 1,246 SWAN women, lean mass fell about 0.2% a year once the transition began, while the rate of fat gain rose from 1% to 1.7% a year [4]. The change is in what your weight is made of.

Why does keeping muscle and strength matter?

Muscle and strength keep everyday life easy. Over the long run, sarcopenia (the age related loss of muscle strength and mass) increases the risk of falls and fractures and makes everyday activities harder [12].

In 232 Finnish women followed across the transition, handgrip strength fell 2.1% and knee extension strength 2.6%. Highly active women went the other way: their grip strength increased [11]. And it's never too late: resistance training improved strength just as much after menopause as before it [13].

Benefits after menopause: muscle mass and strength

Creatine plus resistance training builds more muscle and strength than training alone. Across 22 trials in 721 adults with average ages of 57 to 70, it added 1.37 kg more lean tissue than training alone [14].

Some of the effect shows up fast. In a 2008 trial, 30 women aged 58 to 71 took a loading dose for 7 days with no training and added 1.7 kg to the bench press and 5.2 kg to the leg press. The placebo group did not change [16]. One week of loading partly reflects muscle stores filling with creatine and water, so treat it as a quick start.

Other menopause symptoms

There aren't enough studies yet to recommend creatine for mood, brain fog or other menopause symptoms. The one placebo controlled trial so far was small, lasted 8 weeks and used a different form [21].