TL,DR (too long, didn't read)

Creatine is one of my absolute favorite supplements for women over 40. It helps with brain fog, cognition, and performance in the gym and makes your muscles look full and beautiful.

WHY

Creatine can offer several benefits like augmenting performance, slowing down your fatigue in the gym, and amping up muscle mass and recovery. It has also been shown to help with cognitive capacity. Yet, perhaps perplexingly, myths around creatine persist. I want to address some of these in kind, with some actionable items for you to try in your own life.

WHAT

Myth 1: Creatine Causes Water Retention

Of all the myths surrounding creatine, this is the most common one I encounter from women. Most of us have likely already experienced the annoyance and inevitability of water retention in the luteal phase of the cycle, with rings not fitting, and our pants feeling just a little too snug for our liking.

So it comes as no surprise that if a woman is presented with the slightest inkling of water retention, she will avoid it.

The only issue is… creatine does not cause water retention in the extracellular matrix, but it does so in the intracellular one. There’s debate in the literature as to whether that is short-lived.

Creatine is an osmotically active substance and is taken up into muscle from circulation by a sodium-dependent creatine transporter. [*] Since the transport involves sodium, water also will be taken up into muscle to help maintain intracellular osmolality.

What does that actually mean? The water retention is not outside the muscle, which would lead to more puffiness and inflammation. The water retention is inside the muscle, which only makes the muscle look fuller and more defined.

And even if that is not your jam (full defined muscles), there are several studies that suggest long-term supplementation of creatine does not affect increases in either total body water volume, extracellular water volume, or even intracellular water volume! [*][*]

Although there is some disagreement about this in the literature, [*][*][*] the take-home point is that creatine is not going to make you puffy.

At worst, there is no change in water volume after long-term supplementation, and at best, you increase the water and sodium in the muscle cell which is important for muscle transcription and hypertrophy.

Myth 2: Creatine Is Just For Gym Bros

Much like lifting weights and eating meat has often been ascribed as phenotypical male behavior, creatine is not just for guys. There is ample evidence to suggest creatine supplementation is incredibly useful for women.

Hormone-driven fluctuations can alter your ability to synthesize and transport creatine effectively because creatine synthesis is affected by both estrogen and progesterone levels [*]. And so your ability to make and use creatine will be particularly affected during bleed week, perimenopause, and menopause [*] where we see drastic changes in concentrations of these hormones.

Creatine in the female frontal lobe has also been shown to be lower [*] than our male counterparts. So supplementing with creatine, particularly for women [*], can also help to reduce depression and anxiety.

And ladies in perimenopause and menopause, creatine has been shown to help with almost all measures of improving muscle mass and bone density [*] and reducing inflammation. Inflammaging, as the cool cats call it, is the epicenter of all chronic disease and accelerated aging.

HOW

Grab yourself a bag of creatine monohydrate. It MUST say creatine monohydrate in the ingredient list. No proprietary blend BS. I am asked all the time for recommendations and I absolutely love the Creatine with Taurine from mindbodygreen. (Visit mbg and use code DRSTEPHANIE for 15% off.)

The simplest way to start on creatine is to add 3-5g to your morning smoothie, your water for your workout, or even your coffee. It is flavorless so it will dissolve in just about any liquid and you won’t notice it.

Do this daily and just make it a part of your habit stack. No need to cycle on and off it, just take it consistently. Forever.

Although I find many things wrong with the fitness industry (unrealistic beauty standards, women getting so lean they don’t menstruate, filtered photos, etc.) one thing we can learn from them is their behaviors and habits toward tissue preservation. When fitness competitors are getting stage lean they undergo extreme caloric deficits, but their main goal is to preserve as much muscle as they can. So their protein intake never changes and they never stop taking creatine.

I think that’s more than telling in terms of the value creatine plays in muscle appearance and function.

NOW

• Order your first bag of Creatine with Taurine here. (Use code DRSTEPHANIE to save 15%.)
• Add one scoop to your morning smoothie, workout water, or cup of coffee daily
• After a few weeks, ask yourself if you are noticing changes in your endurance and performance at the gym. Can you go harder for longer? What about your mood? Sleep? Recovery? If this is the only change you make over the next few weeks, you will likely notice several of these markers improving for the better.

Q: Do I take creatine before or after working out? Or does it even really matter when you take it?

Ahhhh, this is SUCH a good question with the possibility of going down several rabbit holes of nerdom. Thank you bltaillon who sent this in via IG. Let’s tuck into this without going TOO overboard, and give you a tangible answer.

So the TL;DR version of this answer is, based on the literature, it doesn’t seem to matter whether you take it before or after exercise. It seems strength gains and hypertrophy gains are all comparable.

For my medium- and dark-roast Bettys who want a little more detail, the largest study to date [*] on the topic of creatine timing involved a 32-week resistance exercise training program. They also had a placebo group so they could monitor the effects of strength training alone.

Thirty-nine healthy, older adults completed the double-blind placebo-controlled design, and were randomized into three groups: “Cr-Before”, “Cr-After”; or placebo (corn starch maltodextrin immediately before and immediately after resistance training).

Following the 32-week intervention, both creatine groups exhibited similar strength gains, with changes greater than the placebo control group.

The best answer here is: just take it when you can easily do it consistently!

I typically take it before training, but that’s because I make my proats (protein powder + oatmeal) and the creatine bag is right beside my protein powder. So they are stacked together for me. I scoop out of one and then just scoop out of the other.

Suggested for You: Another creatine option comes from Equip Foods. Take a look here at the PureWOD Pre-Workout. It includes creatine monohydrate.

YOUR TURN!

I’ll be answering your questions every week right here in the Mini Pause! Let me know what’s on your mind. I’ll be checking for both questions and feedback at support@drstephanieestima.com.

P.S.

In these newsletters, I often share the products, devices, and equipment that I use in my own life regularly. I ONLY mention items I feel are worth highlighting and that I believe may provide health and wellness benefits to my Bettys. I encourage you – pressure-free! – to explore and then determine if any of the items fit YOUR health needs, fitness goals, lifestyle, or budget.

You’ll find more resources in my online HEALTH TOOLKIT. I’ve compiled these for my Bettys who are still cycling, experiencing symptoms of perimenopause, or managing the transition to the other side of menopause. Take a look!

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