Beyond the Gym: Creatine’s Role in Women’s Health

In this episode of Daily Value, we look at the emerging research on creatine supplementation in women’s health—beyond its well-established role in exercise performance. With evidence mounting on creatine’s impact across menstruation, pregnancy, postpartum recovery, and menopause, we discuss how it supports cognition, mood stabilization, and bone health throughout a woman’s lifespan.

Discussion Points:

• Creatine & Hormonal Fluctuations: How estrogen and progesterone influence creatine uptake and metabolism.
• Cognitive & Mood Benefits: The role of creatine in reducing brain fog, fatigue, and potentially postpartum depression.
• Pregnancy & Fetal Development: How maternal creatine status may impact fetal neurodevelopment and birth outcomes.
• Menopause & Bone Health: The effect of creatine on osteoblast activity, muscle preservation, and sarcopenia prevention.
• Dosing Guidelines for Women

https://pmc.ncbi.nlm.nih.gov/articles/PMC7998865/

https://pubmed.ncbi.nlm.nih.gov/39796530/

Chapters

• 0:00 Creatine Impact on Women's Health
• 8:38 Optimizing Creatine Supplementation for Women

Transcript

Speaker 0: 0:00

Creatine, one of the most popular and well-studied supplements in the world. To date, most studies on this topic have been conducted in men, but more and more research the last few years has stressed the importance of and looked at the impact of creatine, specifically in women's health. Today we're going to cover some of that literature. Hello everyone, and welcome back to Daily Value. I'm William Wallace and today we're going to be looking at the health impacts and implications of creatine use in women's health, specifically how it can impact health and function over one's lifespan. But first some background and brushing up on the basics. Creatine is naturally produced in the body in two steps using the amino acids glycine and arginine. Those two amino acids are first converted into guanidino acetate and then, once methylated, converted into creatine Endogenously. Creatine is synthesized primarily in the liver, kidneys and pancreas at an approximate rate of one gram per day. We know that creatine's primary role is to recycle ATP by helping to donate phosphate groups to adenosine diphosphate. Because of this, it comes as no surprise that most creatine in the body can be found in tissues with high energy demand, like neurons, cardiomyocytes. Those are cells of the heart, along with liver cells. But most of creatine 95% of it is stored in skeletal muscle. Now, creatine characteristics differ between males and females. In fact, females produce 20-30% less whole body creatine than males, leaving them with creatine stores that are 70-80% lower compared to males. Additionally, females also report significantly lower consumption of creatine compared to males. This suggests that creatine supplementation may be particularly beneficial for women across different life stages, as endogenous creatine production may not be sufficient to meet physiological demands, particularly during hormonally dynamic phases. More recently, there has been a call to look more deeply into creatine fluctuations throughout a female's different life stages and its importance during menstruation, pregnancy, postpartum, as well as during menopause and post-menopause, as the rate-limiting enzyme in creatine synthesis, that being arginine, glycine and aminotransferase, is influenced by hormones like estrogen and progesterone. Now what we do have is a good deal of evidence showing that creatine is effective for promoting strength and power in exercising females, but especially in premenopausal females.

Speaker 0: 2:34

There is a fear or reluctance of the dreaded water weight gain that has been seen when supplementing with creatine. This is the most common perceived adverse effect of creatine that is transient, meaning only lasting for a short period of time, and seen in the early phases of creatine supplementation. This water retention occurs because creatine is a hygroscopic molecule leading to increased intracellular water content. This can actually enhance cellular hydration and potentially improve muscle recovery. This increase in water retention is observed in women with no significant differences across the menstrual cycle. However, these changes are not observed in long-term studies that run four to six weeks in length, suggesting that the increase in body fluid is again transient. As for other adverse effects of creatine related to kidney function, liver function or cardiovascular function, a 2020 review paper concluded that, barring pre-existing conditions in women, creatine supplementation does not negatively impact these organ systems. As it pertains to the menstrual cycle, fluctuations in estrogen and progesterone influence creatine homeostasis, particularly during the luteal phase, when higher estrogen levels enhance creatine kinase activity. Women experience greater cognitive fatigue during the luteal phase, suggesting that creatine supplementation may improve cognitive function by stabilizing ATP turnover and supporting mitochondrial function. This makes creatine particularly relevant for reducing brain fall or fatigue and cognitive performance declines associated with hormonal shifts, and indeed, research does indicate that creatine supplementation during this phase may support neuromuscular function and reduce performance decrements in women. What I should also add here is that adjusting intake protocols throughout different phases of the menstrual cycle seem unnecessary, in that creatine supplementation appears to provide benefits across the entire menstrual cycle, with no evidence that varying timing of intake or dosages changes or enhances the effects in relation to hormone fluctuation. So it may benefit women more during the alluvial phase, but that doesn't mean dosing and timing of dosing should change throughout the month Moving into pregnancy.

Speaker 0: 4:54

Interestingly, maternal creatine status may influence fetal neurodevelopment and energy metabolism. Not surprisingly, increased metabolic demands brought on by fetal growth and development are associated with a reduced maternal creatine pool. In fact, data in Humans published in 2014 and 2016 found an association between reduced creatine stores during pregnancy and low birth weight and preterm births. The placenta actively transports creatine to the fetus and insufficient maternal creatine stores may compromise fetal growth and increase the risk of neurological deficits. Now, following pregnancy, creatine supplementation may be relevant during the postpartum period, as creatine may support mood stabilization, offering a potential nutritional intervention for something like postpartum depression. In fact, there is strong evidence for creatine improving mood and depression, especially in women. Now I would like to dedicate an entire episode in the future to creatine and its effects on depression, because I feel that's important enough to get its own episode. But early research on this topic did find a positive relationship between creatine found in cerebral spinal fluid and the levels of dopamine and serotonin metabolites. Neuron energetic metabolism is tied to depression, and clinical and preclinical evidence has reported positive effects of creatine supplementation on mood by restoring brain energy levels and homeostasis. The data in humans suggests creatine may be more advantageous to females here. Several studies published in the early and mid-2000s showed that females supplementing with 4-5 grams of creatine daily saw significant improvements in depression compared to non-supplemented females. This supplementation was given in conjunction with antidepressant medication, with effects seen typically at the 2-week mark, which suggested that creatine accelerates the effects of antidepressant medication. Which suggested that creatine accelerates the effects of antidepressant medication, which typically takes four to five weeks to experience noticeable effects.

Speaker 0: 6:52

During menopause, women experience accelerated losses in muscle mass, known as sarcopenia, and bone mineral density, which leads to osteoporosis as estrogen levels drop. While resistance training remains essential, creatine supplementation does seem to provide an additional anabolic stimulus helping to preserve lean muscle mass and musculoskeletal integrity. Mechanistically, creatine's bone protective effects involve an enhanced muscle-bone interaction, increased muscle mass, again with exercise and resistance training leads to greater mechanical loading on bones, promoting osteogenesis. There is also a direct osteoblast stimulation. Creatine kinase supports ATP resynthesis in bone-forming cells, facilitating osteoblast differentiating and function and, lastly, reduced bone resorption. Creatine supplementation has been shown to lower bone. Given these findings, creatine may serve as a valuable intervention alongside resistance training and hormone replacement therapy for post-menopausal women.

Speaker 0: 8:01

For brain saturation, 15-20 grams per day for 3-7 days in divided doses, then followed by 5-10 grams daily for maintenance. A routine daily dose with no loading phase looks like 3-5 grams per day for general health benefits. Now as for optimizing absorption, creatine uptake may be enhanced by insulin-mediated transport. So consuming it with 50 grams of carbohydrates and 50 grams of protein can increase total muscle creatine concentrations. However, given the lower carbohydrate oxidation rates in women, added macronutrients may not always be necessary.

Speaker 0: 8:38

Creatine monohydrate does, after all, have high bioavailability. As it is, a practical strategy may be to take creatine with a meal or add it to a protein shake. Peak absorption occurs when creatine is consumed as a solution rather than capsules or from solid food sources. In conclusion, creatine supplementation is emerging as a powerful tool for women's health beyond athletic performance. From hormonal modulation and neuroprotection to bone preservation and metabolic health, creatine supports functional longevity across different life stages. With its potential applications in cognition, mood, pregnancy and menopause-related concerns, creatine represents an underutilized yet highly effective supplement for enhancing female healthspan. Future research should continue to explore sex-specific dosing strategies and the full spectrum of creatine's benefits across the lifespan. Thank you for tuning in to this episode of Daily Value. As always, stay educated and stay healthy.