Creatine in women's health: bridging the gap from menstruation through pregnancy to menopause

Abstract

Background: Creatine supplementation in women has gained attention for its potential benefits beyond muscle growth, including reproductive health, cognitive health and aging. Women exhibit distinct physiological differences from men, influenced by hormonal fluctuations during pre-menopause, pregnancy, and menopause, and these factors should be considered for their influence on creatine metabolism.

Objective: This review aims to provide a historical evaluation of creatine supplementation in women, its potential applications across female-specific life stages, recent research highlights, and targets for future research. The review also considers the impact of hormonal changes on creatine metabolism and effectiveness as a dietary supplementation.

Methods: This is a narrative overview of historical and recent research evaluating the effects of creatine in women.

Results: Early studies demonstrated the benefits of creatine on exercise performance in women, though they often overlooked menstrual cycle variability. Recent research has begun to account for these hormonal fluctuations, enhancing the understanding of creatine's applications. Creatine supplementation has shown positive effects on muscle strength, exercise performance, and body composition, particularly when combined with resistance training. Additionally, creatine may improve mood and cognitive function, potentially alleviating symptoms of depression. Emerging evidence suggests creatine's benefits during pregnancy and post-menopause, though data on perimenopausal women remains limited.

Conclusion: Creatine supplementation presents a promising strategy for enhancing various aspects of women's health across the lifespan. Future research should focus on optimizing dosing strategies, understanding long-term health implications, and exploring creatine's effects during pregnancy and perimenopause.

Keywords: Creatine monohydrate; female; nutrition; perimenopause; physiology; sleep.

Figure 1.

Theoretical model for the implications for creatine supplementation in females specifically.

Figure 2.

Creatine supplementation may have various targeted effects, dependent upon life stage.

Figure 3.

Timeline of key peer-reviewed manuscripts highlighting the benefits of creatine in females for strength, sport performance, and/or health. Narrative review manuscripts are depicted by outlined circles and were not considered for menstrual cycle control. Notably, to our knowledge, there have been no studies examining creatine in perimenopausal women. In Chilibeck’s study focusing on post-menopause, the average age was 57 ± 6 years, which overlaps with the upper range of perimenopause. Further, literature on the effects of creatine in pregnancy exists, but mostly in animal models. This timeline highlights the need for more menstrual cycle-controlled studies examining the effects of creatine in pre-menopause and the gap of literature in pregnancy and perimenopause.

Figure 4.

Theoretical model for impact of creatine intake during pregnancy.