Boost Muscle, Mood, and Sleep

Creatine is being explored for a wide range of uses, including cognition and brain health, age-related declines in skeletal muscle and bone mineral density, skin aging, neurodegenerative diseases, diabetes, osteoarthritis, and fibromyalgia.

Many of these conditions are experienced by women in perimenopause and menopause.

“During perimenopause, women experience hormonal shifts that can impact energy levels, bone health, and muscle mass,” says Bonnie Jortberg, PhD, RDN, an associate professor of family medicine at the University of Colorado School of Medicine. “Taking a creatine supplement may help to mitigate some of these symptoms and physiological changes.”

Research suggests that women may benefit from creatine supplements because they tend to have lower levels of creatine in their bodies compared with men. They have about 70 to 80 percent less naturally occurring creatine, and they consume significantly lower amounts in their diet.

Estrogen and progesterone levels also affect creatine levels. Creatine levels are lowest when estrogen is at its lowest, such as during the follicular phase (beginning) of the menstrual cycle, amenorrhea (absence of a menstrual cycle), and pregnancy. Levels of creatine are the lowest in postmenopausal women.

“Declining and loss of estrogen and progesterone can reduce creatine levels — which can increase the risk for muscle and bone loss — and mood changes,” says Mindy Goldman, MD, clinical professor emeritus and director of the Gynecology Program for Cancer Survivors and At-Risk Women at the University of California San Francisco. “There is emerging evidence that it might improve bone health, cognition, and mood. There is also some evidence that it may increase resting metabolic rate, which can improve insulin sensitivity, which helps with weight management and maintaining more muscle mass.”

Studies have examined the benefits of creatine supplementation in both premenopausal and postmenopausal women, demonstrating that they can improve strength, exercise performance, bone density and muscle mass, and mood and cognition.

Research evaluating their use in the perimenopausal population has been extremely limited, although one small study recently explored the potential health benefits for women in both perimenopause and menopause. “The study is still undergoing peer review, but the findings are consistent with previous research showing that creatine supplementation coupled with resistance training can support cognitive function, bone health, and muscular health in aging populations,” says the study’s lead author, Lauren Hall, an undergraduate student at St. Olaf College in Minnesota (working under Jenny Miller, PhD, assistant professor of kinesiology). “What’s new — and exciting — is how these benefits extend specifically to perimenopausal women. This group often experiences fluctuating symptoms that aren’t always addressed in traditional menopause research.”

Of note, while both groups experienced improvements in sleep quality, the effect was more pronounced in perimenopausal women.

“This is particularly meaningful because sleep disturbances often begin during perimenopause and can cascade into other health issues,” says Hall. “We observed cognitive improvements in postmenopausal women, which aligns with creatine’s known role in brain energy metabolism. In perimenopausal women, the cognitive effects were more subtle but still promising.”

Hall and her team speculate that, given the hormonal variability during perimenopause, it’s possible that the benefits of creatine are more individualized or require longer-term supplementation to fully manifest.