Creatine and Menopause: What the Research Really Says About Muscle, Mood, and Brain Fog

If you've noticed yourself walking into a room and forgetting why, losing your train of thought mid-sentence, or feeling like your brain is wading through mud, you're not imagining it, and you're not alone. Brain fog is one of the most commonly reported, and often dismissed, symptoms of the menopausal transition.

For years, creatine has had a reputation as a "muscle supplement." But a growing body of research, including a study published just this year specifically on perimenopausal and menopausal women, suggests creatine may do just as much for your brain as it does for your barbell. Let's break down what the science actually shows.

Why Menopause Causes Brain Fog in the First Place

Estrogen isn't just a reproductive hormone. It plays a direct role in regulating blood flow to the brain, supporting energy production inside brain cells, and protecting neurons. As estrogen declines during perimenopause, that support system gets disrupted, and the result shows up as memory lapses, slower recall, and difficulty.

This isn't just anecdotal. Multiple large longitudinal studies have tracked thousands of women through the menopausal transition. These studies have shown dips in learning and memory performance during this menopausal transition. It's a real, measurable phenomenon tied to a genuine shift in how the brain uses energy, not a sign that something is wrong with you.

Where Creatine Fits In

Your brain is metabolically expensive. It makes up about 2% of your body weight but uses roughly 20% of your daily energy. That energy runs largely on a molecule called ATP, and creatine is one of the body's key tools for regenerating ATP. Especially when there are spikes in energy demands.

Creatine does this by increasing the amount of phosphocreatine stored in its cells. When estrogen declines, it puts stress on the brain's energy system. Having more phosphocreatine on hand may help buffer that disruption. Just like how having higher stores of phosphocreatine can provide the energy needed to generate force during heavy training sessions. Higher amounts of phosphocreatine in the brain provide additional energy for cognitive functioning.

What the New Research Shows

Most of the earlier creatine-and-brain research was done in general aging populations, not women specifically navigating the menopausal transition. That changed with the CONCRET-MENOPA trial, a randomized, double-blind, placebo-controlled study published in 2025 that looked specifically at perimenopausal and menopausal women between 40 and 60.

Over eight weeks, women taking a moderate daily dose of a highly soluble creatine formulation (1,500 mg/day of creatine hydrochloride) saw meaningfully decrease in reaction times compared to placebo, along with measurable increases in brain creatine levels. There was also a trend towards improved mood stability, though that finding didn't reach full statistical significance. Importantly, none of the doses tested caused a significant increase in body weight, which is a concern for some women.

This builds on earlier findings, including a 2023 meta-analysis in Nutrition Reviews that found creatine supplementation improved memory performance in aging adults overall, and separate research showing a single dose of creatine can improve cognitive performance and muscle output specifically during sleep deprivation. This is quite important for anyone whose sleep has taken a hit during perimenopause.

It's Not Just About Your Brain

Here's the part that matters just as much for active women: women have naturally lower creatine stores than men to begin with, largely due to lower muscle mass and lower average intake of creatine-rich foods like red meat. That gap means the relative benefit of supplementation is often larger in women, not smaller.

As estrogen declines, muscle loss and strength decline accelerate, which is exactly the window where maintaining lean mass and training capacity matters most. Creatine supplementation paired with resistance training remains one of the best-supported strategies for preserving strength, muscle mass, and bone-loading capacity through this transition. So, the same supplement that may be supporting your focus on a busy Tuesday could also be supporting the squat you're loading up on Wednesday.

The Honest Caveats

I don't want to oversell this. The research on creatine and cognition in midlife women is promising, but it's still early. The 2025 trial had 36 participants; that's a solid, well-designed study, but it's not the same as decades of data. Broader reviews of creatine and cognition in older adults describe the evidence as mixed overall, strongest in people who are sleep-deprived, under metabolic stress, or already have lower baseline creatine stores, and less consistent in healthy, well-rested individuals.

Brain creatine also builds up more slowly and to a smaller degree than muscle creatine does, so if you're taking it hoping for a cognitive effect, patience matters. This is a "give it real time and stay consistent" supplement, not an overnight fix.

The Bottom Line

Creatine is one of the most studied, safest, and most affordable supplements available. The newest research gives us real reasons to think it supports more than just muscle during the menopausal transition. Standard evidence-based dosing is 3–5 grams per day of creatine monohydrate, with no loading phase required. If you're curious about the lower-dose, more soluble forms used in the newer cognition research, that's a conversation worth having with your provider or coach based on your individual health history.

More research is coming, and I'll keep you posted as it does. But if you're already lifting, already prioritizing protein, and looking for one more evidence-backed tool to support both your training and your mind through this transition in life, creatine is definitely worth checking into.

If you want help figuring out how creatine and the rest of your nutrition and training fit together during perimenopause, that's exactly what I’m here for!  [Reach out here] to get started.

References

Gordji-Nejad, A., Matusch, A., Kleedörfer, S., et al. (2024). Single dose creatine improves cognitive performance and muscle force during sleep deprivation. Scientific Reports, 14, 4930.

Gualano, B., Rawson, E. S., Candow, D. G., et al. (2016). Creatine supplementation in the aging population: effects on skeletal muscle, bone and brain. Amino Acids, 48, 1793–1805.

Prokopidis, K., Giannos, P., Triantafyllidis, K. K., et al. (2023). Effects of creatine supplementation on memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials. Nutrition Reviews, 81(4), 416–427.

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.

CONCRET-MENOPA Trial (2025). The Effects of 8-Week Creatine Hydrochloride and Creatine Ethyl Ester Supplementation on Cognition, Clinical Outcomes, and Brain Creatine Levels in Perimenopausal and Menopausal Women: A Randomized Controlled Trial. Journal of the American Nutrition Association.