Why Aren’t More Women Taking This Supplement?
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By Julia Craven
Creatine has been associated with male bodybuilders, athletes, and gym rats since it sprinted into the general public’s knowledge following the 1992 Summer Olympics. I think it’s safe to assume that we don’t think of perimenopausal and postmenopausal women when we think of the supplement.
Perhaps we should. We know that lean muscle mass decreases for men and women after age 35, but the chances of hitting a critical level of decline are higher for women — who tend to have less muscle mass to begin with — and that risk spikes as a woman enters menopause.
As estrogen levels lower, bone and muscle mass loss increases, a shift that can lead to a higher risk of osteoporosis and bone fractures. Other sex hormones are thought to play a role in accelerated muscle loss seen during menopause, too. Drops in testosterone, DHEA (Dehydroepiandrosterone), and progesterone levels could also translate to decreased strength and declines in muscle performance, explained Dr. Karen Adams, a board-certified OB-GYN and North American Menopause Society-certified menopause specialist at the Stanford Health Care Gynecology Clinic.
Research has found that the perimenopausal years are a good time to start figuring out ways to mitigate muscle and bone loss. By incorporating creatine into their routines, perimenopausal and postmenopausal women may be able to enhance exercise performance — boosting their strength and helping to maintain muscle mass for longer, contributing to their overall health and vitality.
“Creatine has been demonstrated repeatedly to improve performance, increase muscle mass, improve mood and sleep, which improves cognition, and now to have a specific impact on bone mineralization when combined with resistance training in postmenopause,” said Dr. Suzanne Gilberg-Lenz, a board-certified OB-GYN and menopause specialist.
Unlike other trendy supplements, creatine’s actually been studied – a lot. The International Society of Sports Nutrition deemed creatine monohydrate as “the most effective ergogenic nutritional supplement currently available” based on decades of research. Creatine is found in muscle cells, and it can help you build strength, increase muscle mass, and improve exercise performance. We get about 60 to 80 percent of our daily stores from foods like chicken, red meat, and seafood. (Some studies have shown that women also consume less dietary creatine than men and appear to store less of it.)
“If you were a car, creatine minorly upgrades the gas tank, and also perhaps gives you more horsepower. This means you will probably be able to work out longer in the gym, squeeze out a couple more reps in the gym, and be a little less fatigued while you do it,” writes Casey Johnston, author of the She’s A Beast, a fitness newsletter. “It is great to take while you are trying to build strength or put on muscle (or both). It is one of the good powders.”
Creatine is indeed very safe for most people. Studies show that three to five grams seems to be the best dosage for optimal absorption. “There really are no statistically significant adverse events reported in the best trials,” said Gilberg-Lenz. And while you may have heard that it’s bad for your kidneys, that’s only for people with pre-existing issues. “Reports of impact on kidney function are not in healthy people.” (Anyone who fits this bill should play it safe and speak with their nephrologist before starting any supplement.)
Though this existing research bodes well for supplementation, studies on how creatine alone can benefit perimenopausal and postmenopausal women, specifically, remain insufficient to craft medical recommendations for this demographic. Most of the research on creatine supplementation is on men, specifically athletes. Those of us who aren’t strength, power, or endurance athletes don’t have the same physical demands. The studies that do look at peri- and postmenopausal women, in particular, don’t show promising results.
A recent review, cited above, specifically looking into the benefits of creatine, concluded that high doses of creatine — 0.3 grams per kilogram of body weight — daily for a minimum of seven days could increase skeletal muscle size and function in postmenopausal women. But two of the paper’s writers have a conflict of interest, noted Adams; they are scientific advisors for a company that commercially markets creatine supplements. (Authors of the ISSN study cited higher in this story list similar conflicts of interest.)
Another study found that taking three grams of creatine every day for two years didn’t affect bone density in postmenopausal women, but it may have boosted lean muscle mass and reduced the risk of fractures — two physical health benefits that strength training alone can accomplish.
For those interested in supplementing with creatine, making an informed decision about the brand you choose is essential. It’s best to stick to brands certified by NSF International and U.S. Pharmacopeia (USP) — two regulatory groups that ensure the sanitation and integrity of products on the market.
“The data on the use of creatine in menopausal women is sparse and mixed. Certainly, there is not enough evidence for us to recommend it right now,” said Adams. “I wish there were more data. We definitely need more research in this area.”