Creatine monohydrate for lean mass, strength, and bone density in postmenopausal women: a systematic review and meta-analysis
Naddafha S, Antonio J, Kreider RB, Stout JR
Journal of the International Society of Sports Nutrition · 2 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Authors
- At least one author declares a financial tie to industry
Based on full-text disclosure statement.
Publication
- Published
- 2026-05-16 · J Int Soc Sports Nutr · vol. 23 · issue 1 · p. 2668435
- Publisher
- Springer Science+Business Media
- Cited
- 2 citations · more than 93% of similar papers · 3.2× the field average
- Impact
- Top 10% most cited in its field
- References
- 31 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Muscle metabolism and nutrition · Diet and metabolism studies · Body Composition Measurement Techniques
- Keywords
- Bone density, Creatine, Postmenopausal women, Clinical nutrition, Creatine Monohydrate, Postmenopausal osteoporosis
- MeSH
- muscle, skeletal, humans, creatine, body composition, postmenopause, bone density, dietary supplements, middle aged, female, muscle strength, randomized controlled trials as topic, resistance training
4 authors
From AU, US
- Siavash Naddafha · correspondingEdith Cowan University
- Jose AntonioNova Southeastern University
- Richard B. Kreider
- Jeffrey R. StoutUniversity of Central Florida
Abstract
Background
Menopause is accompanied by accelerated losses in muscle mass and strength and declining bone density. Whether creatine monohydrate benefits postmenopausal women are uncertain.
Methods
We systematically reviewed randomized, placebo-controlled trials examining creatine supplementation, with or without resistance training (RT), in postmenopausal women. MEDLINE, Embase, Scopus, Web of Science, SPORTDiscus, and Cochrane CENTRAL were searched from 2000 to August 2025, supplemented by trial registries and reference-list screening. Eligible studies included postmenopausal women aged ≥40-45 years, intervention durations ≥6 weeks for primary analyses, and outcomes including DXA-derived lean mass, one-repetition maximum (1RM) strength, bone mineral density, physical function, and safety. Dual screening, duplicate extraction, and Cochrane RoB 2 assessment were performed. Random-effects meta-analysis used the Paule-Mandel estimator for τ² with Hartung-Knapp-Sidik-Jonkman adjustment. Heterogeneity (τ², I²), 95% prediction intervals, subgroup analyses by RT status, exploratory dose/duration meta-regression, small-study effects, and GRADE certainty were assessed.
Results
Seven RCTs (n = 608 randomized; duration 12-104 weeks, median 38 weeks) enrolled postmenopausal women (mean age ≈ 62 y). Lean mass (k = 5; n = 338) favored creatine: mean difference (MD) + 0.37 kg (95% CI + 0.05 to + 0.69; I² = 25%; τ² = 0.01; 95% PI -0.10 to + 0.84). Leg-press 1RM (k = 3; n = 111) improved with creatine: MD + 7.5 kg (95% CI + 2.2 to + 12.8; I² = 0%). Benefits were evident when creatine ≥ 5 g·day⁻¹ was combined with RT; trials using ≤ 3 g·day⁻¹ without RT showed no measurable effect. Bone density was unchanged overall. Adverse events were mild and similar to placebo; renal indices were unchanged. Risk of bias was mostly "some concerns;" one large, preregistered, double-blind RCT was at low risk.
Conclusions
In postmenopausal women, creatine, particularly ≥ 5 g·day⁻¹ with RT, yields small but meaningful gains in lean mass and strength without evidence of harm. Effects on bone density remain unclear.Registration: This review was not prospectively registered. De-identified data and supplementary materials were deposited on OSF after completion of the analysis (DOI: 10.17605/OSF.IO/BVTRZ).
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
Community trust
Loading…
How much do you trust this study's findings?
Comments
Sign in to rate, comment on or flag this study.Sign inSomething wrong here?
Flag this study if its information, labels or funding look wrong. An editor reviews every flag.
Sign in to rate, comment on or flag this study.Sign inEducational information about published research. Not medical advice, and not a recommendation to start or stop anything.