Creatine Isn’t Just for Gym Bros: The Evidence-Based Case for Women in Perimenopause
For years, creatine has been marketed almost exclusively to men — particularly those pursuing strength training or bodybuilding. But recent research has sparked a much-needed shift: creatine is not just a performance enhancer — it’s a deeply therapeutic compound with applications that extend far beyond the gym. And for women entering their 40s and 50s, the benefits may be even more profound.
Im going to put my hand up here and also admit, it wasn’t really something I looked at when prescribing supplements to my clients. However as a naturopath working with women through perimenopause and beyond, I’m always seeking tools that support energy, cognition, mood stability, and metabolic resilience — not just now, but into the decades ahead. Creatine is emerging as a quiet powerhouse in this space.
So what does science tell us?
Creatine is a naturally occurring compound synthesised in the liver, kidneys, and pancreas from three amino acids: arginine, glycine, and methionine. It’s stored primarily in skeletal muscle (around 95%), but also exists in the brain, heart, and other organs.
Its main role is to regenerate adenosine triphosphate (ATP) — the energy currency your cells rely on for every metabolic process. When energy demand spikes (as it does during stress, exercise, or mental effort), creatine donates a phosphate group to help replenish ATP quickly. Without sufficient creatine, this energy system becomes sluggish, leading to fatigue, cognitive fog, and slower recovery.
It’s important to note the body does make creatine endogenously, but it only produces about 1 gram per day — and dietary intake from red meat, poultry, and fish contributes another 1 gram or so. But research shows that supplementation with 3–5 grams daily can saturate muscle and brain stores, supporting a range of biological functions — especially in women, who tend to have 20–30% lower baseline creatine stores than men.
6 Ways Creatine Supports Women’s Health (Especially in Perimenopause)
1. Brain Energy, Cognition + Mental Fatigue
Perimenopause is often described as a “second puberty” for the brain — and for good reason. Oestrogen fluctuations can directly affect brain metabolism, neurotransmitter production, and mitochondrial efficiency. This often shows up as brain fog, difficulty concentrating, word-retrieval issues, or feeling mentally “flat.”
Creatine has been shown to support cognitive performance, particularly in situations where the brain’s energy demand is high. A double-blind study in Psychopharmacology (Rae et al., 2003) found that creatine supplementation (5g/day for 6 weeks) significantly improved working memory and intelligence test scores in healthy adults. Another trial found improved mental fatigue resistance during sleep deprivation and stress (McMorris et al., 2007).
This is especially relevant in women during perimenopause, when declining estrogen may impact cerebral glucose metabolism. Creatine offers a secondary fuel source — buffering the drop in energy and supporting mitochondrial function.
Key takeaway: Creatine may reduce brain fog, enhance clarity, and support cognitive performance during hormonal transition.
2. Muscle Preservation + Metabolism Support
Muscle loss — or sarcopenia — begins as early as our 30s, and accelerates during perimenopause due to declining oestrogen, which normally has a protective effect on muscle mass.
Less muscle means:
Slower metabolism
Less strength and function
Increased risk of insulin resistance
Loss of bone density (muscle exerts mechanical pull on bone)
Creatine has been extensively studied in this context. A 2021 meta-analysis published in Nutrients reviewed 29 trials and found that creatine supplementation combined with resistance training significantly increased lean mass and strength in older adults, including postmenopausal women.
Interestingly, creatine seems to offer anabolic support even in the absence of intense training, making it a uniquely valuable tool for women who aren’t doing heavy lifting or who are recovering from burnout or injury.
Key takeaway: Creatine supports muscle maintenance and body composition during estrogen decline, improving metabolic resilience and physical strength.
3. Mood Regulation + Emotional Resilience
Emerging research suggests that creatine may play a role in mood disorders, particularly depression. This may relate to its effects on:
Brain energy metabolism
Neurotransmitter synthesis (including dopamine and serotonin)
Neuroplasticity and HPA-axis regulation
A 2012 randomized trial published in Biological Psychiatry found that women with major depressive disorder who received creatine alongside SSRI therapy experienced significantly greater improvement in depressive symptoms compared to those who received SSRI alone.
While more research is needed in perimenopausal cohorts specifically, the findings suggest creatine may help stabilise mood during hormonal transitions — particularly when fatigue, low motivation, and anhedonia are part of the picture.
Key takeaway: Creatine may support emotional stability and mood resilience, especially in women experiencing low energy or depressive symptoms.
4. Recovery + Reduced Fatigue
Creatine supports cellular hydration, ATP recovery, and buffering of lactic acid, which collectively enhance recovery after physical or cognitive exertion.
In perimenopause, many women find they no longer “bounce back” the way they used to. Sleep is more disrupted, inflammation is higher, and the body doesn’t repair as efficiently.
Creatine offers a simple way to support repair and recovery, even from everyday stress — not just structured workouts. By improving intracellular hydration and mitochondrial efficiency, it buffers fatigue and shortens recovery time, which is crucial for preventing burnout.
Key takeaway: Creatine can enhance physical and mental recovery — not just from exercise, but from daily stress.
5. Neuroprotection + Anti-inflammatory Effects
Creatine exhibits antioxidant and anti-inflammatory activity, particularly in the brain. It has been studied in neurological conditions such as:
Parkinson’s disease
Multiple sclerosis
Alzheimer’s
Traumatic brain injury
In perimenopause, the risk of neuroinflammation increases — partly due to hormonal shifts, sleep disturbance, and oxidative stress. Creatine may act as a buffer here, helping to protect brain cells from damage, enhance mitochondrial turnover, and improve cellular resilience.
Animal studies also show that creatine reduces pro-inflammatory cytokines and may help to regulate glial cell activation — a key driver of chronic brain inflammation.
Key takeaway: Creatine supports long-term brain health through antioxidant and anti-inflammatory actions.
6. Longevity + Healthy Ageing
Longevity is not just about living longer — it's about maintaining function, clarity, and independence as we age.
Creatine supports:
Muscle mass and strength
Bone density via mechanical loading
Cognitive function and neuroplasticity
Mitochondrial efficiency and cellular repair
Reduced inflammation and oxidative stress
Taken together, this makes creatine a promising addition to any pro-ageing or functional longevity protocol, especially for women navigating the physiological shifts of midlife.
Key takeaway: Creatine supports the pillars of healthy ageing: movement, memory, energy, and cellular repair.
How to Use Creatine Safely and Effectively
Form: Creatine monohydrate is the most well-researched and effective form. It’s stable, bioavailable, and inexpensive.
Dose: 3–5 grams daily is sufficient for most women. No “loading phase” is required.
Timing: Can be taken at any time of day — with or without food.
Hydration: Creatine draws water into cells, so staying well hydrated is important.
Duration: Effects accumulate over several weeks. It’s safe for long-term use in healthy individuals.
Creatine is generally well tolerated, but should be used with practitioner guidance if you have kidney concerns, are pregnant or breastfeeding, or are taking medications.
Creatine is one of the most rigorously studied and underutilised supplements for women. It really does support so many systems that are often under strain during perimenopause: brain, muscle, mitochondria, mood, and recovery.
As a naturopath, I don’t use supplements lightly — but creatine is one I come back to often. It’s not a quick fix, but a foundational support for women who want to feel stronger, clearer, more resilient, and more themselves again — during perimenopause and well beyond.
If you’re curious about working with a naturopath, exploring a personalised protocol, or want to learn more about how yoga therapy, Reiki or EFT might support your health — you’re very welcome to book a free discovery call with me. It’s a chance to have a proper chat, ask any questions, and work out what approach feels right for you.
You can book your free call HERE, or if you’re feeling ready to dive in, you’re also welcome to book an Initial Naturopathic Consultation so we can start creating a personalised plan to get your health back on track — and have you feeling like yourself again.