A note on this article: Creatine has been discontinued from the Proco range — the current lineup is Cognitive Support, Sleep Support, Sleep Formula, Omega-3 and Magnesium Glycinate. We're keeping the research below live because it's still accurate and useful — you just won't find Creatine in our shop.
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
Read the funding line first
Before any of the findings: this is a narrative review, not a systematic review or meta-analysis, which means the authors selected and summarised the literature rather than searching it to a pre-registered protocol. It was published as a "preconference paper" for the Creatine for Health conference 2025, and its funding statement reads: "Alzchem supported the costs to publish this preconference paper." Alzchem manufactures creatine. Two of the authors, including the lead author, disclose serving as scientific advisors to Alzchem.1
That doesn't make the cited studies wrong — most are independent. It does mean the framing is a manufacturer-supported paper's framing, written to argue for more research and more use. Read the numbers; discount the enthusiasm. Our general approach to documents like this is in how to read a supplement label.
Women make and eat less creatine to begin with
The review's baseline finding is a useful starting fact: some reports show 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.1 The starting point, in other words, tends to be lower than the male-dominated research base assumed. Since supplementation works by filling the gap between current and maximum muscle stores, a lower starting point means more headroom — the mechanistic argument for why male data might understate the response in women. Plausible, not demonstrated.
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 synthesis, transport and creatine kinase kinetics. Newer studies are starting to account for cycle phase directly.
Two are worth knowing. A randomised controlled trial of creatine loading versus placebo across the cycle reported significantly greater total body water, extracellular fluid and intracellular fluid with creatine — in the luteal phase, regardless of hormonal contraceptive use, and without a change in body weight. A separate 5-day loading study measured phase angle by bioelectrical impedance, a marker of cellular integrity, and found a greater increase with creatine in the follicular phase (+0.18 ± 0.08°) and a creatine-minus-placebo difference of 0.37 ± 0.17° in the luteal phase.1 These are small, short, mechanism-level outcomes — fluid compartments and impedance values, not strength, mood or symptoms.
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: the gap is total
The review identifies 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. Then it says the thing that matters most: "to date, there is no research directly evaluating the effects of creatine supplementation in perimenopausal women."1 Its own timeline figure repeats it — "to our knowledge, there have been no studies examining creatine in perimenopausal women."
Everything written about creatine and perimenopause is therefore extrapolation from postmenopausal and older-adult trials. Some studies included women in their late 50s, but hormonal status wasn't assessed, so nobody can say who was where in the transition. If you are in perimenopause and reading confident claims about creatine for your symptoms, the evidence behind them is borrowed. What is actually happening cognitively during that window is better covered in perimenopause brain fog: what's actually happening in the brain, and the sleep side in perimenopause and sleep and why sleep changes in your 40s and 50s.
After menopause, the data is real — and modest
Postmenopause is where the foundational female trials sit, mostly in women aged 57 and over. Trials combining creatine with resistance training have shown improvements in strength, lean mass and muscle function; the longest is a two-year randomised controlled trial of creatine plus exercise for postmenopausal bone health, which reported effects on bone geometric properties and lean mass.1
On cognition, the review points to a 2023 meta-analysis in Nutrition Reviews — and here it's worth going to the source, because the review describes it as "a recent systematic review of 23 randomized-controlled trials finding that creatine improved memory compared to a placebo," which overstates it. Twenty-three trials were initially identified; 10 met the inclusion criteria and 8 entered the meta-analysis.2 The pooled result was positive but small: standardised mean difference 0.29 (95% CI 0.04–0.53, p=0.02), with substantial heterogeneity (I²=66%).
The subgroup analysis is the part that changes how you should read it. The effect was carried almost entirely by older adults aged 66–76 (SMD 0.88, 95% CI 0.22–1.55) and was flatly null in participants aged 11–31 (SMD 0.03, 95% CI −0.14 to 0.20, p=0.72, I²=0%).2 Dose (roughly 2.2–20g/day), duration (5 days to 24 weeks), sex and geography did not influence the findings. So: a real memory signal in older adults, no measurable memory signal in younger ones, and nothing specific to women or to perimenopause. We go through the wider cognitive literature and its ceilings in creatine and the brain, and the mood research — including the SSRI-augmentation trial the review leans on — in can creatine support mood.
~20% lower
Women's average creatine synthesis rate compared to men — part of why sex-specific creatine research, long overdue, is only now catching up to the male-dominated evidence base.
Pregnancy: interesting, and almost entirely not human
The review devotes a full section to creatine in pregnancy and perinatal brain injury, and the detail is worth having because it shows exactly how early this is. The prophylaxis evidence comes from animal models: maternal supplementation in a spiny mouse model of birth asphyxia improved offspring survival and organ outcomes; in instrumented fetal sheep, roughly 13 days of supplementation produced a five-fold rise in circulating creatine and about a 60% increase in cerebral creatine content, and creatine prophylaxis reduced hypoxia-induced electrographic seizures by 60% after an acute insult.1 Human dosing and tolerability data is described as still being collected to inform possible randomised trials.
The human data is observational and dietary, not supplemental. Analyses of the US National Health and Nutrition Examination Survey found 57.2% of pregnant women consumed creatine below the recommended amount for an adult female, and that those consuming at least 13mg/kg/day had a lower risk of obstetric conditions than those consuming less.1 That is a cross-sectional association with self-reported diet — and dietary creatine comes from meat and fish, so it is hard to separate from everything else those diets contain. It does not establish that a supplement would do anything. If you are pregnant or breastfeeding, the actual guidance is in our pregnancy and breastfeeding supplement guidance.
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 as they do to men. What's genuinely new is a clearer picture of where women's baseline creatine status differs, and a research agenda aimed at menstrual-cycle, perimenopausal and pregnancy questions the field simply hadn't asked carefully before.
What hasn't changed: the review gives no female-specific dose. Its supplementation section states plainly that there do not appear to be differences required between men and women, and repeats the standard protocols — 20g/day in four 5g doses for 5–7 days, or roughly 5g/day for 3–4 weeks to the same place, then 3–5g/day.1 We've covered why those two routes converge in do you actually need a creatine loading phase, and the wider evidence base in our complete guide to creatine monohydrate.
References
- Smith-Ryan AE, DelBiondo GM, Brown AF, Kleiner SM, Tran NT, Ellery SJ. "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 · Full text: pmc.ncbi.nlm.nih.gov
- 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." Nutrition Reviews, 2023;81(4):416–427. PROSPERO CRD42021281027. pmc.ncbi.nlm.nih.gov
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
Creatine is no longer part of the Proco range. If focus and cognitive performance is what you're after, Cognitive Support is the closest fit in our current lineup. Shop Cognitive Support →