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Creatine for menopause: what trials in women over 50 show for muscle, bone, brain fog and bloating

Creatine is one of the most studied supplements, and trials in women past menopause now cover muscle, bone and, more recently, the brain. They do not all agree. This guide lines up what each trial measured, what it found and how big the effect was, so you can see which claims hold up and which rest on one small study.

Researched and drafted by the Fit Over 40 editorial team. Last updated November 12, 2026. 10 minute read. How we research
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The short version

  • Muscle: a 2026 meta-analysis of seven trials in 608 postmenopausal women found 0.37 kg (about 0.8 lb) more lean mass with creatine than placebo. The range of likely results for a new trial includes zero, so the gain is small and uncertain.
  • Strength is mixed. Leg-press strength was 7.5 kg higher in three trials of 111 women, but in a two-year trial of 237 women both groups gained strength by similar amounts.
  • Bone: a 33-woman pilot suggested less hip bone loss with creatine (1.2% versus 3.9%). The two-year, 237-woman follow-up found no difference in bone density at the hip or spine, only some changes in hip geometry.
  • Brain: the two menopause trials disagree. A 36-woman trial of creatine HCl reported higher frontal brain creatine and faster reaction time. A 51-woman trial of creatine monohydrate found no difference on cognitive tests or brain fog. Both have industry ties.
  • Bloating: the 2026 perimenopause pilot found higher odds of reported bloating with creatine at weeks 4 and 6. Across adult trials, body mass rose about 0.86 kg (1.9 lb), mostly fat-free mass.
  • Safety: the International Society of Sports Nutrition found no compelling evidence of kidney harm in healthy or clinical populations. Creatine can raise creatinine, the blood marker used to estimate kidney function.

Creatine and menopause: the evidence at a glance

Creatine is made in the body and found mainly in red meat and seafood. A typical diet supplies 1 to 2 g a day, which keeps muscle stores about 60% to 80% full, and supplements raise muscle creatine by roughly 20% to 40%.1 Menopause brings faster losses of muscle mass, strength and bone density, which is why researchers have tested creatine in postmenopausal women.2 The table sorts the most common claims by what the trials actually found.

ClaimWhat the trials foundStrength of the evidence
Builds muscle after menopause+0.37 kg (0.8 lb) lean mass across five trials of 338 women2. About +1.1 kg with resistance training in trials of all ages and both sexes3Meta-analyses of randomized trials. Small, and the women-only range includes zero
Makes you strongerLeg press +7.5 kg across three trials of 111 women2. No extra strength gain in a two-year trial of 237 women4Mixed
Protects bone densityNo effect on hip or spine density in the 237-woman, two-year trial4 or in a 2018 meta-analysis5. Less femoral neck loss in a 33-woman pilot6Largest trial negative on density. Some geometry changes, no fracture data found
Clears brain fogOne 36-woman trial found a reaction-time and brain-creatine signal with creatine HCl7. One 51-woman trial found no cognitive or brain-fog difference with monohydrate8Two small trials, both with industry ties
Eases hot flashes or sleepFewer self-reported temperature-sensitivity days, but not significant in a participant-level check (p = 0.064)8One exploratory pilot. Hypothesis only
Causes bloating or weight gainHigher odds of reported bloating in one pilot8. Pooled body mass +0.86 kg across adult trials, mostly fat-free mass9Mixed
Harms the kidneysNo compelling evidence of kidney harm in healthy or clinical populations in an expert position stand1,10. Creatine can raise blood creatinine readings11Expert review, commissioned by an industry trade group
Causes hair lossOne study of young male rugby players found a hormone change (DHT). No study has reported hair loss in humans11Not demonstrated

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Muscle and strength: small gains, clearest with lifting

The newest synthesis is a 2026 meta-analysis of seven placebo-controlled trials in 608 postmenopausal women (average age about 62, trial lengths from 12 to 104 weeks, with or without resistance training). Lean mass measured by DXA in five trials (338 women) was 0.37 kg higher with creatine (95% CI 0.05 to 0.69). Leg-press strength in three trials (111 women) was 7.5 kg, about 16.5 lb, higher (95% CI 2.2 to 12.8).2 The authors concluded that creatine, particularly at 5 g a day or more with resistance training, produced small but meaningful gains with no evidence of harm.2

The lean-mass figure needs a careful read. The 95% prediction interval, which estimates where a new trial's result might fall, ran from -0.10 to +0.84 kg, so it includes zero.2 Pooled analyses with older adults of both sexes look larger, and they point to lifting as the key ingredient.

AnalysisWhoFinding
2026 meta-analysis27 trials, 608 postmenopausal womenLean mass +0.37 kg (0.05 to 0.69). Leg press +7.5 kg (2.2 to 12.8)
Delpino, 20223Randomized trials of all ages, both sexesWith resistance training +1.10 kg (0.56 to 1.65), regardless of age. With mixed exercise +0.74 kg (-3.89 to 5.36), not significant. Without exercise +0.03 kg (-0.65 to 0.70), not significant
Chilibeck, 20171222 trials, 721 men and women, mean age 57 to 70, lifting 2 to 3 days a weekLean tissue +1.37 kg (0.97 to 1.76). Chest-press strength standardized difference 0.35 (0.16 to 0.53)
Older-females analysis, 202113Trials of older women, lifting plus creatineUpper-body strength up (7 studies, 142 women). No effect on lower-body strength or muscle mass
Two-year trial, 20234237 postmenopausal women, mean age 59, lifting and walkingBench-press and hack-squat gains were similar in both groups. In completers, lean tissue rose about 2.3 kg with creatine versus 1.6 kg with placebo (P = 0.046)

Source: the analyses and trial cited in each row. Kilograms convert at 2.2 lb per kg.

Two patterns stand out. Without exercise, the all-age analysis found essentially no lean-mass effect.3 And the two analyses focused on women disagree about lower-body strength: the 2021 analysis found none while the 2026 analysis found a gain, each from only a few small trials.13,2 For the lifting side of the equation, see our guide to strength training after 40, and for the nutrition side, how much protein women over 50 need.

Bone: a promising pilot, then a larger trial that did not confirm it

The first long trial was small. In 2015, 47 postmenopausal women (average age 57) were randomized to creatine at 0.1 g per kilogram of body weight a day or placebo, alongside supervised resistance training three days a week for 12 months. Thirty-three were analyzed. Femoral neck bone density fell 1.2% with creatine and 3.9% with placebo (P < 0.05), and creatine also increased femoral shaft width (subperiosteal width), a predictor of bone bending strength.6

The same group then ran the confirmation. The 2023 trial randomized 237 postmenopausal women (average age 59) to creatine at 0.14 g/kg a day or placebo, with resistance training three days a week and walking six days a week for two years. The registry entry said the team was looking for a difference of about 5% in femoral neck density between groups.14 Femoral neck density went from 0.725 to 0.712 g/cm2 with creatine and from 0.721 to 0.706 g/cm2 with placebo. There was no difference at the femoral neck, total hip or lumbar spine.4 Some hip geometry measures did improve with creatine, including section modulus and the buckling ratio at the narrow part of the femoral neck, which describe how bone resists bending and compression. The authors' conclusion was that creatine had no effect on density but improved some geometric properties.4

A 2018 meta-analysis of trials in adults over 50 or postmenopausal agrees on density. It found no greater effect of creatine plus resistance training than resistance training alone on whole-body, hip, femoral neck or lumbar spine density, although two of the included studies had reported bone benefits.5 That analysis came before the two-year trial.

So the largest trial did not find a density benefit. The geometry findings were secondary outcomes, and we found no trial that tested fractures. In every trial above, all women were lifting, so the real question is what creatine adds to training, not what it does alone. For the bone basics, see osteoporosis after menopause and calcium and vitamin D after menopause.

Brain fog, mood and sleep: two small trials, two different answers

Two randomized trials have tested creatine on brain outcomes in menopausal women. They used different forms of creatine, different doses and different women, which is why their results are hard to combine.

CONCRET-MENOPA (2025)Baker et al. (2026)
Women36 perimenopausal and postmenopausal women, average age 50, four groups751 perimenopausal women, average age 46, randomized 2:2:1 to creatine, placebo or a non-training control8
Creatine form and doseCreatine HCl 750 mg or 1,500 mg a day, or creatine HCl plus ethyl ester 800 mg a day, versus placebo. Not monohydrate7Creatine monohydrate: 20 g a day for 5 days, then about 4.5 g a day as gummies8
Length8 weeks76 weeks of twice-weekly high-intensity lifting after the 5-day load8
Cognitive testsReaction time better than placebo in the 1,500 mg group (p < 0.01)7No difference on Stroop or a 15-word memory test8
Brain measureFrontal brain creatine +16.4% versus +0.9% with placebo in the 1,500 mg group, in a 16-woman imaging subset7,15Prefrontal oxygenation during the Stroop test higher with creatine in the two-group comparison (p = 0.003). The three-group test was not significant (p = 0.083)8
SymptomsMood swings trended better (p = 0.06). Coverage reports less fatigue and fewer concentration difficulties in the 1,500 mg group7,15No difference in brain fog, fatigue or soreness. Fewer temperature-sensitivity days (not significant in a participant-level check, p = 0.064). Sleep consistency 7.4 percentage points higher at week 6 (95% CI 1.5 to 13.3)8
Industry tiesThe team was led by Sergej Ostojic, who has disclosed supplement-industry ties including an advisory board and creatine patents. A company supplied the product free15,16Creatine from AlzChem and Create Wellness. The last author, Abbie Smith-Ryan, reports advisory roles and equity in Create Wellness. A co-author who is a WHOOP employee analyzed the sleep data8

The authors of the 2026 trial call their findings preliminary. The symptom items were unvalidated yes/no journal prompts, there was no correction for multiple comparisons, and each symptom model included only 7 to 13 women per group.8 The CONCRET-MENOPA study did not separate perimenopausal from postmenopausal women.15

Wider memory research does not settle the question either. A 2023 meta-analysis of eight randomized trials in healthy people found a small memory benefit overall (standardized difference 0.29, 95% CI 0.04 to 0.53), driven by adults aged 66 to 76 (0.88) rather than people aged 11 to 31 (0.03).17 A 2024 meta-analysis of 16 trials (492 participants aged 20 to 76) reported gains in memory, attention time and processing speed but not overall cognition or executive function, and found effects in adults 18 to 60 but not over 60, the opposite age pattern.18 Women in their 50s sit between those age groups, and neither analysis was about menopause.

Bloating, weight and hair: what the trials recorded

Bloating. In the 2026 perimenopause pilot, creatine users had higher odds of reporting bloating at week 4 (odds ratio 16.6) and week 6 (7.2) than placebo users, after the 5-day load of 20 g a day.8 The signal came from daily yes/no prompts in small groups. The 2021 expert review adds that single doses above 10 g may cause stomach upset.11

Weight. A 2024 meta-analysis of randomized trials in adults found body mass 0.86 kg (1.9 lb) higher with creatine (95% CI 0.76 to 0.96) and fat-free mass 0.82 kg higher (0.57 to 1.06), with body fat percentage 0.28 points lower (-0.47 to -0.09).9 Fat-free mass includes water. The 2021 review describes short-term water retention in the first days, and in longer trials water changes were often not significant. In one 8-week lifting trial it describes, total body water rose 7.0% with creatine versus 1.7% with placebo, and intracellular water 9.2% versus 1.6%.11

Hair. The worry traces to one study of college-age male rugby players taking 25 g a day for a week and then 5 g a day for two weeks. Dihydrotestosterone (DHT) rose 56% after loading and stayed 40% above baseline, although baseline DHT was lower in the creatine group, and the finding has not been replicated. The 2021 review says no study has reported hair loss in humans, and it does not address women.11

Safety record, and who funded it

The International Society of Sports Nutrition's 2017 position stand describes short- and long-term supplementation, up to 30 g a day for up to 5 years, as safe and well tolerated in healthy people and several patient groups.1 It found no compelling evidence that creatine harms kidney function in healthy or clinical populations.10 The Council for Responsible Nutrition, a supplement-industry trade group, commissioned the review, according to trade press, and several authors of the 2021 follow-up report ties to creatine makers or the society.10,11

The kidney concern traces to a 1998 case report of a young man with an existing kidney disease who had been taking an immunosuppressant for five years. The 2021 review notes that the report ignored how creatine affects creatinine readings, and that similar reports were confounded by medicines and pre-existing disease. In the review of studies it cites, serum creatinine did not rise in 12 studies, rose within the normal range in 8 and rose above it in 2.11 Creatinine is the blood marker used to estimate kidney function, and the review advises caution when interpreting creatinine-based estimates in people who supplement.11 The postmenopausal trials above enrolled generally healthy volunteers, so they say little about women who already have kidney disease.14,7

What we still do not know

  • Whether creatine builds muscle in postmenopausal women who do not lift. The all-age analysis found no lean-mass effect without exercise.3
  • Whether 5 g a day or more beats lower doses. The suggestion comes from the authors' interpretation of seven trials.2
  • Whether the hip geometry changes seen after two years translate into fewer fractures. We found no fracture data.4
  • Whether creatine HCl's brain-creatine signal replicates, and whether monohydrate raises brain creatine in menopausal women. The 2026 pilot measured prefrontal oxygenation, not brain creatine.7,8
  • Whether the temperature-sensitivity and sleep signals survive a larger trial with validated symptom scales.8

Questions to take to your clinician

  • Do my kidney function or any medicine I take change whether creatine makes sense?
  • Should my lab report note that I take creatine, since it can affect creatinine readings?
  • Is my lifting program enough that a supplement is worth testing, or should training and protein come first?

Related guides:

Common questions

Does creatine work after menopause?

For muscle, modestly. A 2026 meta-analysis of seven trials in 608 postmenopausal women found 0.37 kg (about 0.8 lb) more lean mass with creatine and 7.5 kg more leg-press strength in three trials, but the prediction interval for lean mass included zero.2 Across all ages, the lean-mass gain appeared with resistance training (1.10 kg) and not without exercise (0.03 kg).3

Does creatine increase bone density in postmenopausal women?

Not in the largest trial. In 237 women followed for two years, creatine plus lifting and walking did not change bone density at the femoral neck, total hip or lumbar spine, although some hip geometry measures improved.4 A 2018 meta-analysis also found no extra density benefit.5 A 33-woman pilot had reported less femoral neck loss, 1.2% versus 3.9%.6

Does creatine help menopause brain fog?

The evidence is thin. A 36-woman trial of creatine HCl reported faster reaction time and higher frontal brain creatine in the 1,500 mg group.7 A 51-woman trial of creatine monohydrate found no difference on cognitive tests or self-reported brain fog.8 Both were small, and both have industry ties.15,8

Does creatine help hot flashes or sleep?

One exploratory pilot of 51 perimenopausal women reported fewer temperature-sensitivity days and higher sleep consistency with creatine. The temperature result was not significant in a participant-level check (p = 0.064), the symptom items were unvalidated yes/no prompts, and there was no correction for multiple comparisons.8

Does creatine cause bloating or weight gain?

Across adult trials, body mass rose about 0.86 kg (1.9 lb), most of it fat-free mass, which includes water, while body fat percentage fell slightly.9 In a 2026 pilot of perimenopausal women, creatine users had higher odds of reporting bloating at weeks 4 and 6 after a 5-day load of 20 g a day.8

Is creatine safe for women over 50?

The International Society of Sports Nutrition's 2017 position stand found no compelling evidence of kidney harm in healthy or clinical populations and described studies of up to 30 g a day for up to five years as safe and well tolerated.1,10 Creatine can raise serum creatinine, the marker used to estimate kidney function, so the 2021 expert review advises caution when interpreting those estimates in people who supplement.11 An industry trade group commissioned the position stand, according to trade press.10

Do I need to lift weights for creatine to work?

The evidence says lifting matters. In an all-age meta-analysis, creatine with resistance training added 1.10 kg of lean mass, while creatine without exercise added 0.03 kg, which was not statistically significant.3 The 2021 expert review likewise concludes that creatine alone is unlikely to produce substantial strength or functional gains.11

Is creatine monohydrate or creatine HCl better for menopause?

We found no head-to-head trial in menopausal women. The two-year bone trial and the 2026 perimenopause pilot both used monohydrate.4,8 The one menopause brain trial that reported benefits used creatine HCl and creatine HCl plus ethyl ester at 750 to 1,500 mg a day, compared with placebo only.7

References

  1. Kreider RB, Kalman DS, Antonio J, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18. https://pmc.ncbi.nlm.nih.gov/articles/5469049/
  2. Creatine monohydrate for lean mass, strength, and bone density in postmenopausal women: a systematic review and meta-analysis. J Int Soc Sports Nutr. 2026;23(1):2668435. https://pubmed.ncbi.nlm.nih.gov/42141930/
  3. Delpino FM, et al. Influence of age, sex, and type of exercise on the efficacy of creatine supplementation on lean body mass: a systematic review and meta-analysis of randomized clinical trials. Nutrition. 2022;103-104:111791. https://pubmed.ncbi.nlm.nih.gov/35986981/
  4. Chilibeck PD, Candow DG, Gordon JJ, et al. A 2-yr randomized controlled trial on creatine supplementation during exercise for postmenopausal bone health. Med Sci Sports Exerc. 2023;55(10):1750-1760. https://pubmed.ncbi.nlm.nih.gov/37144634/
  5. Forbes SC, Chilibeck PD, Candow DG. Creatine supplementation during resistance training does not lead to greater bone mineral density in older humans: a brief meta-analysis. Front Nutr. 2018;5:27. https://pmc.ncbi.nlm.nih.gov/articles/PMC5928444
  6. Chilibeck PD, et al. Effects of creatine and resistance training on bone health in postmenopausal women. Med Sci Sports Exerc. 2015;47(8):1587-1595. https://doi.org/10.1249/MSS.0000000000000571
  7. Korovljev D, et al. The effects of 8-week creatine hydrochloride and creatine ethyl ester supplementation on cognition, clinical outcomes, and brain creatine levels in perimenopausal and menopausal women (CONCRET-MENOPA): a randomized controlled trial. J Am Nutr Assoc. 2025. https://pubmed.ncbi.nlm.nih.gov/40854087/
  8. Baker PA, DelBiondo GM, Kelly CG, Johnson WM, Grosicki GJ, Smith-Ryan AE. Creatine supplementation effects on cognition, sleep, and menopause symptoms in response to six weeks of high-intensity resistance training in perimenopausal females. Eur J Appl Physiol. 2026. https://doi.org/10.1007/s00421-026-06481-6
  9. Creatine supplementation protocols with or without training interventions on body composition: a GRADE-assessed systematic review and dose-response meta-analysis. J Int Soc Sports Nutr. 2024. https://doi.org/10.1080/15502783.2024.2380058
  10. NutraIngredients. Experts confirm safety and efficacy of creatine supplements (coverage of the 2017 ISSN position stand). June 14, 2017. https://www.nutraingredients.com/Article/2017/06/14/Experts-confirm-safety-and-efficacy-of-creatine-supplements
  11. Antonio J, Candow DG, Forbes SC, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr. 2021;18:13. https://doi.org/10.1186/s12970-021-00412-w
  12. Chilibeck PD, Kaviani M, Candow DG, Zello GA. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access J Sports Med. 2017;8:213-226. https://pmc.ncbi.nlm.nih.gov/articles/PMC5679696
  13. Efficacy of creatine supplementation combined with resistance training on muscle strength and muscle mass in older females: a systematic review and meta-analysis. Nutrients. 2021;13(11):3757. https://pmc.ncbi.nlm.nih.gov/articles/PMC8619193
  14. ClinicalTrials.gov NCT02047864. Effect of creatine supplementation and exercise on bone health (University of Saskatchewan). https://clinicaltrials.gov/study/NCT02047864
  15. PsyPost. Coverage of the CONCRET-MENOPA trial, including funding, disclosures and limitations. 2025. https://www.psypost.org/?p=229733
  16. NutraIngredients. Research deepens into creatine and the menopause transition. September 12, 2025. https://www.nutraingredients.com/Article/2025/09/12/research-deepens-into-creatine-and-the-menopause-transition
  17. Prokopidis K, Giannos P, Triantafyllidis KK, et al. Effects of creatine supplementation on memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2023;81(4):416-427. https://pmc.ncbi.nlm.nih.gov/articles/PMC9999677
  18. NutraIngredients. Review explores creatine as cognitive enhancer (coverage of Xu C, et al., The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis, Front Nutr 2024). July 25, 2024. https://www.nutraingredients.com/Article/2024/07/25/review-explores-creatine-as-cognitive-enhancer/
About this article

Every health claim above links to its source. It is general information and cannot take your personal history into account, so use it to prepare for a conversation with your own clinician.

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