Creatine : a proven supplement for women in midlife

Midlife women are the largest consumers of supplements, most of which are not proven to be beneficial in the absence of deficiency. Creatine, however, may be a supplement worth taking.

Creatine has long been associated with male athletes and bodybuilding, but this is rapidly changing. High-quality research now shows clear benefits for women, especially during midlife, when maintaining muscle, bone, mood and cognitive health becomes increasingly important.

What does creatine do?

Creatine is a naturally occurring compound made from three amino acids (glycine, arginine, methionine). The brain and body each produce around 1–3 g per day, and a further 1-3 g comes from food—mainly meat and fish.

Its primary role is to help rapidly regenerate ATP, the “quick energy” molecule your cells use for almost every high-intensity or high-demand task. Although 95% of creatine is stored in skeletal muscle, the brain also relies on creatine, especially during periods of stress or increased metabolic demand.

Because women typically have ~70–80% lower intramuscular creatine stores than men—and these stores decline with age—the potential upside of supplementation is even greater.

Why creatine matters more in midlife

1. Muscle strength & lean mass

Midlife is when women experience accelerated loss of muscle mass and strength. Studies consistently find that creatine combined with resistance training improves:

• muscle strength

• power

• lean body mass

• training quality.

Women respond at least as well as men—sometimes better—because they start with lower baseline stores.

2. Brain health, cognition & “brain fog”

Creatine supports brain energy metabolism and has shown benefits particularly when the brain is under stress, including:

• sleep deprivation

• concussion or mild TBI (traumatic brain injury)

• high cognitive load

• mood disorders

• intense physical stress.

Studies show improved cognitive performance under these conditions, although research specifically on everyday “brain fog” is still emerging.

There is also early data supporting creatine as an adjunctive therapy for depression, with improved mood scores and enhanced SSRI response.

3. Bone health

Creatine may support bone density by improving:

• muscle strength → higher mechanical load on bone

• cellular energy in osteoblasts

• performance during weight-bearing exercise.

Creatine alone is not a bone medication—but it amplifies the bone-building effect of resistance training.

Dosage recommendations for women in midlife

The first ~5 g/day of supplemented creatine is preferentially absorbed by muscle—especially in women who exercise regularly.

This means less creatine is available to cross the blood–brain barrier, which is why brain-focused dosing is typically higher.

For muscle, bone & general health

5 g/day of creatine monohydrate.

This is safe, effective, and well studied.

For brain, mood & cognitive support

10 g/day, divided into 1–2 doses.

Why more?

• The first ~5 g saturates skeletal muscle.

• Additional creatine increases availability to the brain.

• Higher doses have been used safely in research examining concussion, sleep deprivation, and depression.

Take consistently for 4–6 weeks, then continue long-term at 5–10 g/day depending on training load and goals.

Types of creatine

The most studied and reliable form is creatine monohydrate.
Other forms (HCl, buffered, ethyl-ester) have no proven advantage and are often more expensive.

Choose a product that is:

• third-party tested

• plain powder

• free of fillers or additives

Do you still need to exercise?

Yes!
Creatine works best when paired with:

• resistance training (2–4 days per week)

• weight-bearing activity

• high-intensity short bursts

It’s not a magic powder—it’s an amplifier.

Safety & potential side effects

Creatine is one of the safest and most researched supplements in sports and clinical nutrition.

Common, mild side effects:

• temporary water retention (1–1.5 kg)

• mild bloating in some women

• slight stomach upset if taken on an empty stomach

• cramping is rare (usually dehydration-related).

Creatine does not harm kidneys in healthy individuals (elevated creatinine, commonly used as a measure of kidney function, is due to increased creatine metabolism). Those with exisiting kidney disease should seek medical advice.

Long-term use (even 5–10 years) has been shown to be very safe.

Reference list

Smith-Ryan AE et al., Creatine Supplementation in Women’s Health: A Lifespan Perspective. Nutrients. 2021. PMCID: PMC7998865. PubMed Central

Smith-Ryan, A. E., et al (2025). Creatine in women’s health: bridging the gap from menstruation through pregnancy to menopause. Journal of the International Society of Sports Nutrition

Kreider RB et al., Safety and efficacy of creatine supplementation in exercise. JISSN (review). (JISSN summary of daily needs ~1–3 g/day). BioMed Central

Avgerinos KI et al., Effects of creatine supplementation on cognitive function (systematic review). (and related reviews on brain). Frontiers+1

Lyoo IK et al., Randomized, double-blind trial: Creatine augmentation for SSRI treatment in women with MDD. 2012. PubMed Central

Bakian AV et al., Dietary creatine intake and depression risk among U.S. adults. 2020 (observational analysis). Nature

Roschel, H., Gualano, B., Ostojic, S. M., & Rawson, E. S. (2021). Creatine Supplementation and Brain Health. Nutrients, 13(2), 586. Nutrients