Creatine monohydrate stands out as one of the most renowned ergogenic aids, and its reputation is well-deserved. This blend of the amino acids (methionine, glycine, and arginine) has undergone extensive examination for its impact on sports performance. However, what many people overlook is the broader spectrum of benefits creatine offers beyond pure athletic endeavors. Its supplementation is likely advantageous for women navigating menopause and the aging population, as well as those adhering to a plant-based diet.

Women and Menopause

Women, unfortunately, remain underrepresented in research, even more so in the field of creatine and muscle mass. Despite decades of exploration, the full extent of creatine’s effects on women remains elusive. A study by Brosnan and Brosnan suggests that women possess only 70% to 80% of the endogenous creatine stores that men have. Endogenous creatine is highest in women during reproductive years. During this time, women’s creatine kinase levels fluctuate throughout the month, peaking during ovulation and the luteal phase, coinciding with an estrogen surge, and declining as women age into menopause and beyond. Given that the spike in endogenous creatine kinase aligns with estrogen fluctuations, it is logical to observe a decrease in endogenous creatine levels as estrogen diminishes with age. Consequently, postmenopausal women are likely to gain significant benefits from creatine supplementation. 

A double-blind placebo-controlled study suggests that post-menopausal women taking at least 0.1 g per kg per day of creatine may experience improved bone mineral density when coupled with three days a week of resistance training over 12 months. Additionally, these women experienced a significant improvement in their bench press strength when taking creatine. It is important to acknowledge that not all studies have yielded the same outcome strength for bone mineral density as is observed with improved muscle strength. For instance, a two-year randomized, placebo-controlled study involving post-menopausal women taking 0.14 g per kg per day of creatine experienced no discernible improvement in bone mineral density, while also performing resistance training three days a week. Albeit, they did register a modest yet significant improvement in bone bending strength, a factor critical in mitigating fall-related injuries and an increase in lean muscle tissue. The proper amount of creatine is an important component to consider, as studies indicate that small servings of creatine, such as 1 g daily, fail to support improvements in muscle mass or bone density parameters among postmenopausal women. 

Aging Population

Muscle mass typically peaks in the 20s, remaining relatively stable through the 40s, before gradually declining by about 12% to 15% each decade thereafter, often leading to sarcopenia or age-related muscle loss. By supporting muscle mass, creatine emerges as a valuable ally for both men and women, aiding their quest for strength and vitality as they age. The link between increased muscle mass and longevity underscores the importance of preserving muscle integrity over time, a principle that appears to be particularly true for women. 

While creatine may confer muscle-promoting benefits without resistance exercise, current research presents mixed results. However, when coupled with resistance training, creatine’s effects on muscle mass are more pronounced. Resistance training stands out as one of the most impactful methods for increasing type 2 fibers, the very fiber that appears to be most susceptible to atrophy in age-related sarcopenia. In a meta-analysis of 721 participants, individuals ages 57 to 70, both men and women, who supplemented with creatine while engaging in two to three days a week of resistance training for a minimum of seven weeks experienced greater overall lean muscle mass and increased upper and lower body muscle strength, compared to individuals of the same age who did not incorporate creatine into their regimen. 

Plant-Based Diet

While plant-based diets offer the potential of many health benefits, it is imperative to acknowledge that certain nutrients, including specific forms of vitamins that are more bioavailable for humans, minerals, and creatine, are exclusively sourced from animal products. Individuals adhering to a plant-only diet obtain no exogenous creatine and rely solely on endogenous production. Humans synthesize approximately 1 g per day of creatine, with an additional 1 g derived from meat consumption. Depending on the inclusion of animal byproducts in one’s diet, creatine may be consumed in small amounts in eggs and dairy, but more predominantly in meat tissue such as in beef, pork, and chicken. Although creatine resides in animal foods, it is important to note that creatine supplements are not synthesized from, nor do they contain, any animal byproducts. 

Compared to omnivores, vegetarians appear to exhibit lower serum and muscle levels of creatine, although brain levels appear no different. Based on a study done on women, transitioning from an omnivorous diet to a vegetarian diet may lead to a decline in their creatine stores after three months if not supplementing. Although creatine supplementation may benefit the general population, since vegans and vegetarians have lower serum creatine levels, they may stand to gain more from supplementation than omnivores. In a controlled study comparing vegetarian and non-vegetarian young women, researchers observed that supplementing with 0.3 g per kg of lean mass per day of creatine for five days resulted in a slightly more significant increase in serum creatine levels among the vegetarian group compared to the omnivorous group.

Learn more about the versatility of creatine:

Creatine Monohydrate for Healthy Aging

Creatine for Weight Management, Cognitive Performance, and Healthy Inflammatory Responses

Effects of Creatine on Brain Health and Function

By Melanie Luther, CHN, MS