Have you ever wondered if creatine supplementation recommendations are the same for women as they are for men?
By Hannah Cabré, PhD(c), RDN, CISSN
- Creatine supplementation is beneficial for general health and exercise performance in women.
- Weight gain associated with creatine supplementation is largely an unsubstantiated side effect in women.
- A loading phase of creatine is not necessary, so a pre-workout with creatine in it is a great option.
As a woman, you have probably looked for supplement recommendations and found that they are mostly made for men and based on research in men. Additionally, you may have been told that you should not take certain supplements because of their potential undesired side effects, like weight gain from creatine monohydrate supplementation.
Well, I’m here to tell you that creatine monohydrate supplementation is one of the most beneficial supplements for women’s health and exercise performance. Creatine monohydrate is one of the most studied sport supplements and the research demonstrates it is very effective for exercise performance, power, and muscle growth.
But, is that true in women? If so, are the recommendations for supplementation different for women?
My team and I have studied creatine monohydrate specifically in women, so let’s jump into the science.
WHY IS CREATINE MONOHYDRATE BENEFICIAL FOR WOMEN?
There are sex-based differences that exist between men and women regarding creatine, which suggests that women may benefit from creatine supplementation even more than men (1).
Here are some facts:
- Women have 70-80% lower whole body internal creatine stores compared to men.
- Women see changes in important enzyme activity and ability to store creatine over the menstrual cycle, during pregnancy, post-partum, and during and post-menopause.
- Women experience higher rates of depression compared to men, which has been tied to creatine levels in the brain.
So, supplementing with creatine monohydrate increases the internal stores of creatine possibly counteracting some of these sex-based differences. It is very beneficial as a daily supplement for women’s health even outside of exercise. However, creatine supplementation when paired with exercise is even more effective.
Creatine supplementation has been shown to significantly improve muscular strength and power in both trained and untrained women. Longer-term supplementation studies (>10-12 week) and shorter-term supplementation studies (5 days) have both shown increases in muscle size, strength, and power even in a variety of dosing strategies and dose amounts (1). This means that taking creatine consistently can aid in effectively increasing strength and power when paired with resistance training. These significant increases have been attributed to an increase in muscle stores of phosphocreatine (the storage form of creatine), which helps increase training intensity and recovery between exercise sets. If you are looking to increase muscular size, strength, and power while resistance training, creatine supplementation is a strategy you need to be using.
Creatine supplementation is also beneficial for aerobic exercise performance. The increase of muscle phosphocreatine helps prevent fatigue, increases energy availability in the muscle, and helps maintain balanced pH levels. One study found that only 3 days of creatine supplementation increased sprint cycle performance in NCAA Division I athletes and that the effect was greater in females as the sprints were repeated (2). Another study in endurance training showed creatine supplementation increased total time to exhaustion while decreasing heart rate and breathing rate during a running test to exhaustion (3). If you are an athlete or individual who must compete in more than one event or game on the same day, or who must compete on successive days, creatine supplementation can help you recover faster and optimize your performance.
Despite these benefits of creatine supplementation in women, a recent survey shows less than 20% of women use creatine (4). The most common reason for not using creatine supplementation was fear of weight gain. So, is this an actual concern for women taking creatine?
WILL CREATINE MONOHYDRATE MAKE ME GAIN WEIGHT?
The short answer: Most likely, no.
The long answer:
- Most of the research demonstrating weight gain with creatine supplementation is in men. Research in women has not consistently shown the same finding.
- Weight may rapidly and temporarily increase with a loading dose BUT is mostly a reflection of an increase in cellular hydration, not a change in muscle or fat.
- Creatine supplementation is often recommended to be consumed with 1.0 gram of carbohydrate per kilogram of body weight- this is probably not a necessary strategy for women.
Women may see weight changes across the menstrual cycle as estrogen and progesterone fluctuate, directly impacting cellular fluid distribution. In the luteal phase, right after you ovulate and before your period, the fluid distribution may negatively influence exercise performance. Creatine supplementation has been shown to increase total body water and help the cells pull more water in thereby counteracting negative fluid shifts that occur during the luteal phase. This increase in cellular fluid can help with thermoregulation and exercise performance.
A recent study examining fluid distribution and exercise performance over the menstrual cycle found that body weight did not change across the menstrual cycle or with a loading dose of creatine (20 grams of creatine for 5 days) (5). However, there was an increase in total body water in the luteal phase with creatine supplementation. This was paired with improved exercise performance demonstrating how creatine supplementation can positively influence fluid distribution and exercise performance across the menstrual cycle without changing body weight.
Now that the myth of weight gain has been addressed, it’s time for you to start taking creatine.
WHAT ARE THE TIMING AND DOSING RECOMMENDATIONS FOR CREATINE MONOHYDRATE?
Creatine supplementation can be accomplished two ways: using a loading phase or taking a daily dose of 5 grams. Both are equally effective for increasing muscle creatine stores, however, only taking 5 grams per day takes more time (~3 to 4 weeks) to see the same increase in storage (1).
Pros of a loading phase:
- Has demonstrated a 19% increase in total muscle creatine concentrations, which is similar to the response seen in men.
- Creatine remains elevated for about 30 days following completion of supplementation.
- The same dosing strategy for males is also beneficial for females.
Cons of a loading phase:
- It takes a lot of time: 20 grams per day for 5 days is usually separated out into consuming 5 grams of creatine four times over that day; then repeated for five days.
- If you miss a dose, or doses, over the day, it may not be as effective.
- There could be non-responders to a loading phase.
A loading phase can be beneficial but starting with 5 grams of creatine per day consistently will be just as effective. A pre-workout with creatine monohydrate is a great option as you will gain the benefits from the creatine plus benefits from the other supplement ingredients to fuel your workout and improve your exercise performance.
SHIFTED includes 5 grams of creatine monohydrate (the most effective form of creatine) in their maximum pre-workout formulation. As discussed, taking creatine, especially in a pre-workout, will most likely not cause weight gain. Creatine supplementation for women is effective and is important for improving muscle storage, maximizing exercise performance, and aiding in fluid regulation.
1. Smith-Ryan AE, Cabre HE, Eckerson JM, Candow DG. Creatine Supplementation in Women’s Health: A Lifespan Perspective. Nutrients. 2021 Mar 8;13(3):877. https://pubmed.ncbi.nlm.nih.gov/33800439/
2. Ziegenfuss TN, Rogers M, Lowery L, Mullins N, Mendel R, Antonio J, et al. Effect of creatine loading on anaerobic performance and skeletal muscle volume in NCAA Division I athletes. Nutrition. 2002 May;18(5):397–402. https://pubmed.ncbi.nlm.nih.gov/11985944/
3. Nelson AG, Day R, Glickman-Weiss EL, Hegsted M, Kokkonen J, Sampson B. Creatine supplementation alters the response to a graded cycle ergometer test. Eur J Appl Physiol. 2000 Sep 15;83(1):89–94. https://pubmed.ncbi.nlm.nih.gov/11072779/
4. Benton M, Spicher J, McCormick S. Community-Based Survey Exploring Use of the Dietary Supplement Creatine by Adult Non-Athletes. Nutrients. 2021 Jul 24;13(8):2529. https://pubmed.ncbi.nlm.nih.gov/34444689/
5. Moore SR, Gordon AN, Cabre HE, Hackney AC, Smith-Ryan AE. A Randomized Controlled Trial of Changes in Fluid Distribution across Menstrual Phases with Creatine Supplementation. Nutrients. 2023 Jan 13;15(2):429. https://pubmed.ncbi.nlm.nih.gov/36678300/
Hannah Cabré is a registered dietitian and a doctoral candidate in the Human Movement Science Curriculum at UNC Chapel Hill School of Medicine. Her research interests focus on the effects of exercise and nutrient timing on body composition, cardiorespiratory fitness, and metabolic health, specifically women.
She is passionate about optimizing women’s health across the lifespan through feasible nutrition and exercise interventions. Her current work assesses the influence of hormonal contraception on strength and recovery outcomes across the menstrual cycle.