Creatine has more human trial evidence behind it than almost any supplement — but for decades, most of that evidence came from studies of men. A 2025 review in the Journal of the International Society of Sports Nutrition pulls together what's actually known specifically about women, across the menstrual cycle, pregnancy, and the menopause transition, and where the real gaps still are.1
Women make and eat less creatine to begin with
The review's baseline finding is a genuinely useful starting fact: women have roughly 20% lower creatine synthesis rates than men, and on average 30-40% lower dietary creatine intake, since dietary creatine comes almost entirely from meat and fish. That combination means the starting point — how much creatine is already in the body before any supplementation — tends to be meaningfully lower for women than the male-dominated research base assumed.
The menstrual cycle question is finally being asked properly
Earlier creatine research mostly didn't control for where in the menstrual cycle female participants were tested — a real methodological gap, since estrogen and progesterone both influence creatine metabolism. Newer studies are starting to account for cycle phase directly, which matters for interpreting results going forward, though the review is clear that this is still an early, developing area rather than a settled one.
Women synthesize roughly 20% less creatine and eat 30-40% less of it on average than men — a baseline difference the research base is only now starting to properly account for.
Perimenopause is where the review puts the most weight
The review's lead author specifically flagged the transition into menopause as the period of greatest interest — the phase where women commonly report sleep disruption, bone density loss, muscle loss, joint pain, fatigue, brain fog, and increased inflammation, several of which have plausible creatine-related mechanisms (muscle protein synthesis, cellular energy metabolism). Good-quality data already exists for creatine's benefits after menopause is established; the perimenopausal transition itself is the area still catching up.
Pregnancy: a genuinely early research area
The review also covers emerging, still-limited research into creatine's potential role in supporting perinatal brain health and protecting against brain injury around birth. This is real, active research territory — but "emerging" is the accurate word; it is not yet established, dosing- or safety-confirmed guidance for pregnancy. (If you're pregnant or breastfeeding, see our full pregnancy/breastfeeding supplement guidance before starting or continuing creatine.)
What this changes, practically
The core, well-established benefits of creatine — muscle strength, exercise performance, body composition when paired with resistance training, and a growing cognitive-function evidence base — apply to women just as they do to men; nothing here undercuts that. What's genuinely new is a clearer picture of where women's baseline creatine status differs, and a research agenda specifically aimed at menstrual-cycle, perimenopausal, and pregnancy-specific questions that the field simply hadn't asked carefully before. The review doesn't give a female-specific dosing recommendation beyond standard guidance — timing and individual goals remain the deciding factors either way.
References
- Smith-Ryan AE, et al. "Creatine in women's health: bridging the gap from menstruation through pregnancy to menopause." Journal of the International Society of Sports Nutrition, 2025;22(1). tandfonline.com
This article is for informational purposes only and has not been evaluated by the FDA. It is not intended to diagnose, treat, cure, or prevent any disease. If you are pregnant, breastfeeding, or navigating perimenopause with new or worsening symptoms, speak with your doctor before starting or changing any supplement.
Related reading: Perimenopause Brain Fog: What's Actually Happening in the Brain
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