Hormone health
Creatine in Perimenopause and Menopause: What the Newest Research Shows
Three new studies examine what creatine may do for muscle, bone, brain fog, and mood in midlife women—and where the evidence still has limits.
Dr. Cosette Stahl, DO
Founder & Physician, Vital Coeur Health · 3 min read
September 14, 2026
Gain over placebo in a 2025 meta-analysis of 608 women.
Creatine preserved hip bone geometry despite no change in density.
Levels rose in regions tied to mood and memory in CONCRET-MENOPA.
As estrogen declines, women lose muscle and bone faster and often report more brain fog. Estrogen influences all three. Creatine is stored in both muscle and brain, where it helps regenerate cellular energy. These new trials asked a practical question: can supplementing it make a measurable difference?
Muscle & strength
A 2025 meta-analysis of seven randomized controlled trials involving 608 postmenopausal women found modest but real gains: 7.5 kg more leg-press strength and 0.37 kg more lean mass than placebo.
The important catch: benefits appeared only at doses of 5 g/day or more when paired with resistance training. Creatine without training did not produce the same result.
Bone
A two-year randomized controlled trial in 237 postmenopausal women found no additional improvement in bone density compared with exercise alone. But the creatine group maintained hip bone geometry — the bone’s resistance to bending and compressive stress.
That structural benefit matters because a standard DEXA scan measures density, not every aspect of bone strength.
Brain fog & mood
The 2025 CONCRET-MENOPA trial studied 36 women ages 40–60 for eight weeks and directly measured brain creatine for the first time. Creatine increased in frontal brain regions associated with mood and memory.
At 1,500 mg/day, participants also reported less fatigue and fewer concentration problems, and they showed faster reaction times without weight gain.
Keep this in perspective: this was a small trial and the results need to be replicated. Still, it offers the first direct connection between menopause-related brain fog and a potentially modifiable energy mechanism.
Practical takeaway
Creatine monohydrate
3–5 g daily, paired with resistance training twice weekly for at least 24 weeks. In the 2025 analysis, measurable benefits appeared at 5 g/day or more.
Creatine HCl
750–1,500 mg daily was studied. This is newer evidence and is best individualized with your physician.
Creatine monohydrate has a strong long-term safety record, with mild gastrointestinal upset among the most common side effects. Talk with your physician before using it if you have kidney disease or take medications that affect kidney function.
One supplement is never the whole plan.
Your biology deserves an integrated plan.
Vital Coeur connects your labs, hormones, nutrition, and strength programming in one physician-led plan — so decisions like this are made for your biology, not guessed at alone.
Explore our integrated care model →Referenced research: CONCRET-MENOPA (2025), Journal of the American Nutrition Association; 2025 meta-analysis of creatine monohydrate in postmenopausal women; 2025 review of creatine in women’s health, Journal of the International Society of Sports Nutrition; two-year randomized controlled trial of creatine plus exercise for postmenopausal bone health.
This article is for educational purposes and is not a substitute for individualized medical advice. Talk with your physician before starting creatine or any new supplement.