Creatine in women: why it can be an ally at every stage of life
Author: Sara Matesanz – @salud.hormonal
Creatine has been one of the most studied supplements in the world, but for years it has been associated almost exclusively with male athletic performance. However, current science is clear: women not only benefit from creatine, but in many cases may benefit from it more than men due to their physiological, muscular, and hormonal characteristics.
From the menstrual cycle to perimenopause, creatine repeatedly appears as a safe, simple, and effective support for improving energy, strength, recovery, and overall well-being.
What is creatine and why does it matter for women
Creatine is a compound that the body itself produces and stores as a small “rapid battery” to generate energy immediately. Although we also obtain it from foods such as meat and fish, many women have lower reserves, whether due to lower muscle mass, lower protein intake, or hormonal variations.
Recent research indicates that:
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Women tend to have lower total muscle creatine.
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Estrogen and progesterone modulate its synthesis and use.
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Pregnancy, perimenopause, and menopause can increase energy demands.
All of this makes creatine particularly relevant throughout the female life cycle.
As Smith-Ryan et al. (2021) summarize, creatine in women should be understood “from a lifespan perspective”, not merely as an acute resource for improving training performance.
Creatine, the menstrual cycle, and feelings of energy
Many women notice monthly fluctuations:
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Greater tiredness during the luteal phase and menstruation.
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Better performance and feelings of energy during the follicular phase.
The study by Benito et al. (2023) suggests that recovery after high-intensity efforts may be less efficient during certain phases of the cycle (such as the luteal phase) compared with the follicular phase, pointing to variable energy demands throughout the month.
Creatine supplementation has not been extensively tested phase by phase, but because of its role in the rapid regeneration of ATP:
- It could help make feelings of fatigue somewhat more stable across phases.
- It may make it easier to tolerate training on days when the body “asks for more.”
Realistically: “creatine does not eliminate menstrual fatigue, but it may make it somewhat more manageable” when combined with good habits involving rest, nutrition, and movement.
Cognition, mental clarity, and mood
The brain also uses the creatine–phosphocreatine system as an energy buffer. In situations of high demand (stress, lack of sleep, heavy mental load), having adequate reserves may help neurons maintain their function more effectively.
In women, current reviews report:
- Small improvements in mental clarity, memory, and reasoning in contexts of fatigue or insufficient sleep.
- A possible positive impact on the feeling of mental load, especially during phases of the cycle when discomfort or PMS intensifies.
In addition, some small clinical studies have observed that adding creatine to antidepressant treatment may accelerate or enhance improvement in certain depressive conditions, with particularly interesting results in female populations. This has led researchers to suggest that creatine could have a “potentially antidepressant profile.”
Even so, the key idea is one of caution:
- Creatine is not a psychological or psychiatric treatment.
- It may be considered gentle metabolic support for emotional stability and stress tolerance, always as part of a professional mental health approach when needed.
Muscle, strength, and recovery
This is the area where the evidence is strongest, including in women:
- Creatine increases the ability to produce force and power during short, repeated efforts.
- Combined with strength training, it promotes gains in lean muscle mass.
- It facilitates recovery between sets and between intense sessions.
In everyday life, this translates into:
- Being able to train with better quality even during phases of the cycle when perceived exertion is higher.
- Making a strength program more effective in the long term, which is key for bone health, fall prevention, and maintaining functionality, especially during perimenopause and postmenopause.
Creatine on its own does not change body composition: its role is to help make training more productive and sustainable.
Fertility, pregnancy, and reproductive health
Creatine is present in:
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Follicular fluid
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Reproductive tissues
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Fetal–placental unit
Studies suggest that it could:
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Contribute to oocyte quality
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Help in situations of high energy demand
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Provide support during early embryonic development
Some data suggest that greater creatine availability in the ovarian environment could be associated with better oocyte quality in contexts of high energy demand. However:
- There is insufficient evidence to recommend creatine as a fertility treatment.
- During pregnancy, most research is preclinical or observational, so its use cannot be recommended generally.
In this area too, creatine should be understood as possible complementary metabolic support, always within broader reproductive strategies supervised by the medical team.
Perimenopause and postmenopause
The loss of muscle mass and strength accelerates during these stages. For this reason, studies in middle-aged women highlight that creatine:
- Improves strength
- Preserves muscle mass
- Indirectly contributes to better bone health
- Promotes long-term functionality and independence
Simple support that helps make strength training —the most important activity at this stage— more effective.
Dose, practical use, and safety
The most extensively studied form of creatine is creatine monohydrate, used in most clinical trials and reviews (Kreider & Stout, 2021).
Most common dosage
- 3–5 g per day of creatine monohydrate, continuously.
- It can be taken at any time; consistency is the most important factor.
- Loading phases (higher doses for several days) are not necessary to obtain benefits and may increase the likelihood of digestive discomfort.
What you can expect from creatine
Putting everything into context:
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Menstruation: slight reduction in fatigue, better tolerance of training.
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Follicular phase: a strong complement during days of naturally higher energy.
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Luteal phase and PMS: may improve mental clarity and soften the drop in energy.
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Perimenopause and postmenopause: promotes strength, lean mass, and functionality.
And above all, “creatine works as a support, not as a standalone solution.” It makes a difference when combined with:
- Well-planned strength training.
- Reasonable sleep and rest.
- Adequate nutrition.
- Medical and psychological treatments when necessary.
References
- Muccini AM, Tran NT, de Guingand DL, et al. Creatine Metabolism in Female Reproduction, Pregnancy and Newborn Health. Nutrients. 2021;13(2):490. PMID: 33540766.
- Pinto CL, Botelho PB, Pimentel GD, Campos-Ferraz PL, Mota JF. Creatine supplementation and glycemic control: a systematic review. Amino Acids. 2016;48(9):2103–2129. PMID: 27306768.
- Gualano B, de Salles Painneli V, Roschel H, et al. Creatine in Type 2 Diabetes: A Randomized, Double-Blind, Placebo-Controlled Trial. Med Sci Sports Exerc. 2011;43(5):770–778. PMID: 20881878.
- Benito PJ, Alfaro-Magallanes VM, Rael B, et al. Effect of Menstrual Cycle Phase on the Recovery Process of High-Intensity Interval Exercise—A Cross-Sectional Observational Study. Int J Environ Res Public Health. 2023;20(4):3266. PMID: 36833959.
- Smith-Ryan AE, Cabre HE, Eckerson JM, Candow DG. Creatine Supplementation in Women’s Health: A Lifespan Perspective. Nutrients. 2021;13(3):877. PMID: 33800439.
- Kreider RB, Stout JR. Creatine in Health and Disease. Nutrients. 2021;13(2):447. doi:10.3390/nu13020447.
- de Guingand DL, Palmer KR, Callahan DL, et al. Creatine and pregnancy outcomes: a prospective cohort study of creatine metabolism in low-risk pregnant females. Am J Clin Nutr. 2024. doi.org/10.1016/j.ajcnut.2023.11.006.