The supplement that could transform your perimenopause
Suddenly struggling to open a jar that never gave you trouble before? Finding yourself Googling "why am I so tired" for the third time this week? Walking into a room and completely forgetting why you're there?
If you're in your 40s or early 50s, you're probably nodding along. And whilst you've likely heard about HRT, evening primrose oil, and magnesium for perimenopause, there's one supplement that's been hiding in plain sight in the bodybuilding aisle that researchers are now calling a potential game-changer for midlife women: creatine.
Let's break down what creatine actually is, why it might be worth considering during the hormonal rollercoaster of midlife, and how to use it safely and effectively.
What is creatine?
Creatine is a naturally occurring compound made from three amino acids – arginine, glycine and methionine. It's found in small amounts in foods like red meat and fish, and it's also produced by our own bodies – mainly in the liver and kidneys. Around 95% of the body's creatine is stored in muscle tissue, with the brain storing about 5%.
Think of creatine as an energy reserve for your cells – particularly your muscles and brain. It helps regenerate a molecule called ATP (adenosine triphosphate), which is the body's main energy currency.
Here's how it works: creatine converts to phosphocreatine in your cells, acting as a rapid energy buffer during the first few seconds of intense activity. The more efficiently your body can recycle ATP, the better your muscles and brain can perform under pressure.
Traditionally used for strength and performance
Creatine has long been one of the most researched supplements in the sports world. Decades of studies demonstrate that it helps increase strength, muscle mass and exercise performance, especially in high-intensity activities like weight training or sprinting.
It's so well established that it's often called the "gold standard" of sports supplements – safe, effective, and backed by solid evidence. But what's now coming to light is that creatine's benefits go far beyond the gym – and may be particularly relevant for women navigating midlife.
Why creatine could be a game-changer in perimenopause
During perimenopause, fluctuating oestrogen levels can have widespread effects on the body – not just on mood and temperature regulation, but also on muscle mass, bone density, brain function and energy production at a cellular level.
Here's the science: when oestrogen declines, so does our mitochondrial efficiency – the powerhouses that produce ATP. This is partly why fatigue hits so hard during perimenopause, even when you're getting adequate sleep.
Here's how creatine may help support women through these changes:
1. Protecting muscle and strength
Women can lose up to 3-5% of muscle mass per decade after age 30, with accelerated loss during the menopausal transition when oestrogen drops significantly. Oestrogen plays a crucial role in maintaining lean muscle, so as levels decline, many women experience noticeable muscle loss and reduced strength.
Research demonstrates that creatine supplementation helps counteract this by enhancing muscle protein synthesis whilst reducing muscle protein breakdown – a double benefit during hormonal transitions. Studies consistently show that creatine works synergistically with resistance training to preserve strength and muscle mass, helping you maintain the vitality and functional strength that supports everyday life.
2. Supporting brain health and mental clarity
Creatine isn't just for muscles – it's also used by the brain as an energy source. Emerging research suggests women may have naturally lower brain creatine levels than men, making supplementation potentially more impactful for us.
Studies indicate that creatine supports cognitive function, mood and mental energy, particularly during times of stress, fatigue, or hormonal fluctuation. A 2024 review of multiple randomised controlled trials found improvements in processing speed, memory and mental fatigue in women supplementing with creatine.
For women in perimenopause who experience brain fog, low motivation or mental fatigue, creatine could offer subtle yet meaningful support for clarity and focus.
3. Boosting energy and combating fatigue
Many women describe perimenopause as feeling like their batteries drain faster than they used to. Because creatine helps the body recycle energy more efficiently at the cellular level, research demonstrates it can improve overall energy availability – both mentally and physically.
By supporting mitochondrial function and ATP production, creatine addresses one of the root causes of perimenopausal fatigue, rather than just masking symptoms.
4. Bone health (emerging evidence)
Whilst research is still developing in this area, preliminary studies suggest creatine may work synergistically with resistance training to improve bone mineral density, particularly in postmenopausal women. It appears to support bone health both directly and indirectly – by promoting muscle strength and function, which in turn helps protect bone density and reduce fall risk as we age.
The research gap that's finally closing
Here's something important to know: historically, most creatine research focused on young male athletes. Thankfully, more studies on women – and specifically midlife women – are now emerging, showing promising results that validate what many practitioners and women themselves are experiencing firsthand.
Who might benefit most from creatine?
Creatine supplementation may be particularly helpful if you're:
Doing resistance or strength training (even if you're just starting out)
Experiencing significant brain fog or difficulty concentrating
Struggling with persistent fatigue despite getting adequate sleep
Noticing loss of muscle tone or strength
Looking for evidence-based support during your perimenopausal transition
How to use creatine
The most researched and commonly used form is creatine monohydrate. It's widely available, affordable, and well tolerated by most people.
Here's what you need to know about using it:
Dosage: A common approach is 3–5g daily. There's no need for a "loading phase" (which you may see in gym-focused guidance); simply take it consistently each day.
Timing: You can take it at any time – with or without food – though pairing it with a meal that includes some carbohydrates and protein may improve absorption.
Hydration: Creatine helps your muscles hold on to water, so it's important to stay well hydrated throughout the day.
Patience: It can take a few weeks of consistent use before you notice a difference in energy, strength, or mental clarity.
Is creatine safe?
For most people, creatine is very safe when used at recommended doses. It's been studied extensively – even in older adults and women – with few adverse effects reported. Some people may experience mild bloating or water retention at first, but this often settles within a week or two.
As with any supplement, it's always best to check with a qualified practitioner or your GP before starting, especially if you have kidney issues or other medical conditions.
The nutritional therapy perspective
When I work with women in perimenopause, I look beyond symptoms to understand what's happening beneath the surface – whether that's changes in hormones, nutrient status, energy production, gut health, or stress resilience.
Creatine is one small piece of a much bigger picture. For some women, it can be a helpful addition to a personalised plan that supports strength, cognition and vitality. But to get the best results, it's important to identify why your body might be struggling with fatigue, low motivation or loss of muscle tone in the first place. That's where a nutritional therapy approach can really make a difference.
My go-to creatine
If you're thinking about trying creatine, this is the brand I personally recommend and use myself and with my clients – it's pure, high quality and well absorbed. You can also get 10% off through this link: https://gb.healf.com/ANDREAHARDY
(The discount link above is an affiliate link which means we both get rewarded. I never recommend products that I would never use myself or in my own practice.)
Ready to feel more like yourself again?
If you'd like to explore how creatine – alongside nutrition and lifestyle strategies – could support you during perimenopause, I'd love to chat.
I work with people to create practical, sustainable nutrition strategies that support how they want to feel and perform – both now and in the years ahead.