Creatine is now one of the most researched nutritional supplements available, and there is growing interest in its potential role in women's health, healthy ageing, muscle function and possibly brain health.

So, should women over 40 consider taking it?

For some women, the answer may be yes.

What actually is creatine?

Creatine is a naturally occurring compound made by the body from amino acids. We also obtain small amounts through foods, particularly meat and fish.

Most of the creatine in our body is stored in skeletal muscle, where it helps rapidly regenerate ATP – the energy our muscles use during short, high-intensity activities such as lifting weights, jumping or sprinting.

Taking creatine increases the amount stored in the muscles, giving them greater capacity to rapidly produce energy.

This can help you train harder and, over time, may support improvements in strength and muscle mass.

Why are we talking about creatine after 40?

Maintaining muscle becomes increasingly important as we age.

From midlife onwards, women become more vulnerable to losing muscle mass and strength. The menopause transition also brings changes in hormones, body composition and sometimes physical activity.

This is why progressive resistance training remains one of our most important tools for healthy ageing.

Creatine may provide an additional benefit.

A recent systematic review and meta-analysis specifically examining postmenopausal women found that creatine supplementation produced small improvements in lean mass and strength, particularly when doses of at least 5 g/day were combined with resistance training.

The important part?

Creatine doesn't replace strength training – it may help you get more from it.

Will creatine make me bulky?

No.

Creatine doesn't suddenly produce large muscles, and it doesn't increase body fat.

Some people notice a small increase in body weight when they first start taking creatine because additional water is stored inside the muscle cells.

This isn't the same as gaining fat.

In fact, that increased cellular hydration is part of the normal physiological response to creatine.

What type should I take?

You don't need a fancy formulation.

The most extensively researched form is:

Creatine monohydrate.

Despite supplements advertising special blends or more expensive forms of creatine, there is little reason for most people to choose anything more complicated.

How much do I need?

A simple approach is approximately:

3–5 grams of creatine monohydrate per day.

It can be taken at any convenient time of day and mixed into water, a smoothie or another drink.

Some protocols use a “loading phase” of approximately 20 g per day, divided into several doses for 5–7 days, to saturate the muscles more quickly.

However, loading isn't necessary.

Taking a smaller daily dose will still gradually increase muscle creatine stores – it simply takes a little longer.

Consistency matters more than perfect timing.

Is creatine safe for your kidneys?

This is one of the biggest misconceptions surrounding creatine.

In healthy people, research has not shown that recommended creatine supplementation damages kidney function.

Creatine can cause a small increase in blood creatinine, which is commonly measured when assessing kidney function. This can sometimes create confusion because higher creatinine may make calculated kidney function appear different even when the kidneys themselves are functioning normally.

If you take creatine and are having blood tests, it is therefore worth telling your doctor.

Women with existing kidney disease or significant medical conditions should discuss supplementation with their doctor before starting it.

What about hair loss?

Another common internet claim is that creatine causes hair loss.

Current evidence does not support this.

In fact, a recent randomised controlled trial directly examining hair follicles, hair density and hormones found no evidence that creatine caused hair loss.

Could creatine help the brain too?

This is where research becomes particularly interesting.

The brain requires a large amount of energy, and creatine also plays a role in brain energy metabolism.

Research is investigating whether supplementation could support aspects of memory, cognition, mood and mental fatigue, particularly during periods of increased metabolic demand or sleep deprivation.

There is also growing interest in whether women may respond differently because creatine metabolism appears to interact with hormonal changes across the female lifespan.

However, we need some perspective.

The evidence for creatine's effects on muscle and exercise is considerably stronger than the evidence for preventing cognitive decline or improving menopausal “brain fog”.

So while brain health is an exciting area of research, we shouldn't yet describe creatine as a proven treatment for cognitive symptoms of menopause.

Do I need creatine if I eat meat?

Not necessarily – but eating meat doesn't mean supplementation can't have an effect.

We obtain creatine from foods such as:

- red meat

- pork

- chicken

- fish

Vegetarians and vegans generally consume less dietary creatine and may therefore have lower baseline stores.

Supplementation provides considerably more creatine than we would usually obtain from a normal serving of food.

Is creatine essential?

No.

You don't need creatine to be healthy, strong or active.

If you're deciding where to invest your energy first, focus on the fundamentals:

strength training, adequate protein, good nutrition, regular physical activity and sufficient recovery.

Creatine is an optional addition, not a replacement for any of them.

How can physiotherapy help?

Supplements alone don't build strong bodies.

If your goal is to maintain muscle, bone and physical capacity through your 40s, 50s and beyond, the most important question isn't simply:

"Should I take creatine?"

It is also:

"Am I giving my muscles enough reason to become stronger?"

A physiotherapist can help you establish an appropriate progressive resistance program based on your current strength, injuries, bone health, pelvic health and goals.

Creatine may help support the process.

But ultimately, the training provides the stimulus – and your body provides the adaptation.

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References

Antonio, J., Candow, D. G., Forbes, S. C., et al. (2021). Common questions and misconceptions about creatine supplementation: What does the scientific evidence really show? Journal of the International Society of Sports Nutrition, 18, 13.

Antonio, J., et al. (2025). Part II. Common questions and misconceptions about creatine supplementation: What does the scientific evidence really show? Journal of the International Society of Sports Nutrition.

Candow, D. G., et al. (2026). Creatine monohydrate for lean mass, strength, and bone density in postmenopausal women: A systematic review and meta-analysis.

de Guingand, D. L., et al. (2025). Creatine in women's health: Bridging the gap from menstruation through pregnancy to menopause.

Forbes, S. C., Candow, D. G., Ferreira, L. H. B., & Souza-Junior, T. P. (2022). Effects of creatine supplementation on properties of muscle, bone, and brain function in older adults: A narrative review. Journal of Dietary Supplements.

Longobardi, I., et al. (2025). Effect of creatine supplementation on kidney function: A systematic review and meta-analysis. BMC Nephrology.

Smith-Ryan, A. E., Cabre, H. E., Eckerson, J. M., & Candow, D. G. (2021). Creatine supplementation in women's health: A lifespan perspective. Nutrients, 13(3), 877.

Tinsley, G. M., et al. (2025). Does creatine cause hair loss? A 12-week randomized controlled trial. Journal of the International Society of Sports Nutrition.

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