Creatine for Women and Brain Health: What the 2025 Research Shows

Creatine builds muscle. Everyone knows that. What almost nobody is talking about is what it does to the female brain.

I covered the creatine meta-analysis on muscle last week. Today is a different story. The research on creatine, women, and cognition has accelerated fast in 2024 and 2025 — and the findings are remarkable enough to change how I think about who should be taking it and why.

This isn't the muscle post. This is the brain post.

What the research actually shows

A 2021 review by Smith-Ryan et al. published in Nutrients established a critical starting point: females have 70–80% lower endogenous creatine stores than males. Not slightly lower — dramatically lower. Because creatine is found almost exclusively in animal muscle tissue, and because female dietary protein intake tends to run lower on average, the gap between creatine need and creatine supply is larger in women from the start. The review found strong evidence that supplementation improves mood, cognition, and brain energy homeostasis in females — particularly by restoring phosphocreatine stores in brain tissue that had been chronically depleted.

A 2024 narrative review by Gutiérrez-Hellín et al. in Nutrients expanded on this, noting that women eating plant-based or lower-protein diets have reduced creatine stores that directly impair both physical and cognitive performance. This is a significant finding for vegans and vegetarians who often default to avoiding creatine because they associate it with bodybuilding. The data says they're the ones who need it most.

The most striking work is a 2025 randomised controlled trial by Korovljev et al. published in the Journal of the American Nutrition Association. They enrolled 36 perimenopausal and menopausal women in a double-blind, placebo-controlled trial. The medium-dose creatine group saw reaction time improve significantly, frontal brain creatine levels increase measurably, serum lipid profiles improve, and a strong trend toward reduced mood swings. Brain creatine was actually measured directly via spectroscopy — this isn't speculation about mechanism, it's direct tissue-level confirmation.

What this means for you

The brain runs on ATP. When energy demand exceeds supply — during intense mental effort, sleep deprivation, high stress, or the hormonal shifts of the menstrual cycle — the phosphocreatine system acts as a rapid buffer. It donates phosphate groups to ADP to regenerate ATP in seconds. If that buffer is low, you notice it as brain fog, poor concentration, and slow reaction times.

Creatine replenishes that buffer in brain tissue the same way it does in muscle. The dosing that appears effective for cognitive outcomes is 3–5 g per day — lower than traditional muscle-loading protocols. Timing matters less for cognitive effects than for muscle; the key is consistency, not peri-workout timing.

For women eating plant-based, low-protein, or low-meat diets, I'd treat creatine the same way I treat vitamin B12 — a straightforward gap to close. You're not supplementing beyond normal; you're restoring what the diet can't provide.

And for the perimenopausal and menopausal years? The 2025 RCT data is specific enough to be clinically useful. This is a hormonal environment where brain energy metabolism shifts, mood regulation becomes harder, and cognitive complaints are common. Creatine isn't a hormone — but it addresses the energy metabolism layer of those symptoms directly.

The biotype angle

Ectomorphs eating lower-protein diets are the group most likely to be chronically creatine-depleted. They also tend to have higher baseline cortisol relative to anabolic hormones, which increases brain energy demand. Creatine for an ectomorph isn't about muscle — it's about giving the nervous system the buffer it needs to perform under load.

Endomorphs with high carbohydrate diets typically have adequate muscle creatine, but the cognitive benefits still apply — especially if they're in a caloric deficit, which reduces total creatine intake from food.

Mesomorphs see the most well-documented muscle performance benefits. But if you're in training camp, exam season, or a high-output work period, the brain benefits are real and additive.

One thing I get asked: does creatine cause water retention or bloating? In the loading phase (20 g/day for 5–7 days), yes — you'll hold intramuscular water. At the maintenance dose of 3–5 g per day with no loading phase, the research shows minimal water retention. For women concerned about this, skip the loading phase entirely. Take 3–5 g daily for 4 weeks. The phosphocreatine stores will saturate gradually with no noticeable bloating.

Download the free Biotype Guide at milenium.com.au
→ milenium.com.au

References:
1. Smith-Ryan AE et al. Creatine Supplementation in Women's Health: A Lifespan Perspective. Nutrients, 2021. DOI: 10.3390/nu13030877
2. Gutiérrez-Hellín J et al. Creatine Supplementation Beyond Athletics. Nutrients, 2024. DOI: 10.3390/nu17010095
3. Korovljev D et al. Effects of Creatine Supplementation on Cognition in Perimenopausal and Menopausal Women. Journal of the American Nutrition Association, 2025. DOI: 10.1080/27697061.2025.2551184