At menopause, the ovaries almost stop making hormones. Oestrogen falls to less than 1% of its former level, and muscle is among the first to feel it. These hormones play a part in the force of contraction and in rebuilding muscle fibres. Their decline first takes away strength and power, then muscle mass, especially when activity and protein drop, which often happens at this age.
Muscle also becomes less sensitive to what makes it grow, effort and protein. Researchers call this anabolic resistance. A woman who eats and trains exactly as she did at 25 will not get the same result at 55. I go into this in more detail in the article on what changes in your body during perimenopause.
This is often when creatine comes into the conversation. After 45, it is one of the supplements I am asked about most, and many of the pages about it come from brands that sell it. A meta-analysis published in May 2026 brings together the trials carried out in postmenopausal women.
A well-studied supplement, far less so after menopause
Creatine is one of the most widely studied supplements in the world. Women naturally store 20 to 30% less of it than men, and diet alone cannot make up the difference. In postmenopausal women, though, the question remained open, for want of an overview of the trials.
Seven trials and 608 postmenopausal women
Siavash Naddafha's team in Australia, working with American researchers, pooled seven randomised placebo-controlled trials (Naddafha et al., 2026). In total, 608 postmenopausal women with an average age of about 62, followed for 12 weeks to two years. In some trials the women also did strength training, in others they did not.
For lean mass, measured by DEXA scan in five trials, creatine added 0.37 kg more than placebo. For strength, measured on the leg press in three trials, the women taking creatine lifted 7.5 kg more than those on placebo. Side effects were mild and as frequent as with placebo, and kidney markers did not change.
0.37 kg of lean mass is modest, and lean mass also includes water. The strength gain says more. Strength is what lets you get up, carry things and catch yourself after a stumble, and it is the first thing menopause takes away.
Without strength training, no measurable effect
The benefit only shows up in the trials where creatine went with a strength training programme. In those where women took it without training, at lower doses, the researchers measured no effect at all.
This is what I keep telling the women I work with. Neither hormone therapy, nor a diet, nor a supplement does as much for the body as strength training. Women who train regularly with weights and eat enough protein see their bodies change. Creatine comes on top of that work, once it is in place. If you are torn between buying a tub of creatine and joining a gym, start with the gym.
Nothing for bone density
The meta-analysis also looked at bone density and found nothing. With or without creatine, it did not change. The authors conclude that the effect on bone remains unclear. If you were thinking of taking it for your bones, this meta-analysis does not back that up.
Bone and muscle work together, and anything that makes the muscle work also sends the bone a signal to get stronger. Protein, strength training and hormone therapy, when it is an option, protect bone well before any supplement does. One woman in two will have a fracture linked to osteoporosis in her lifetime, and that is where your effort belongs.
The limits of the study
This meta-analysis did not measure mood, concentration or tiredness, which other studies are looking into.
The gains are modest, and the authors themselves rate most trials as having "some concerns" for risk of bias. Only one large trial, registered in advance and double-blind, is rated low risk. The review itself was not registered before it was carried out. One of the authors has ties to Alzchem, a creatine manufacturer, which also funded part of the publication.
None of this cancels out the result. The figures point the same way as what we already know about strength training after menopause, and they promise nothing spectacular.
Before you take it
Creatine draws a little water into the muscles. The scales can go up by a kilo or two without a single gram of extra fat. If you track your weight, also look at your waist measurement and the weights you lift in training, they tell you more about what is happening.
Which creatine to choose and how much, I set out in Your Body Through Menopause and Beyond, along with everything that comes first, protein, training and sleep. Before taking any supplement, talk to your doctor, especially if you have a health condition or are on treatment.
If you want to go further and adapt all this to your body and your life, I offer one-to-one and group coaching.
This article is for information only and does not replace medical advice.