§.01The study, in one paragraph.
Researchers searched eight databases (PubMed, Cochrane CENTRAL, Embase, Web of Science, Scopus, CINAHL, PsycINFO, ClinicalTrials.gov) through July 2025 for RCTs that tested supplements combined with structured exercise in women. They included trials examining whole proteins, amino acids, amino-acid derivatives, or creatine monohydrate vs exercise alone or placebo+exercise. Outcomes: muscle mass (primary), strength, bone health, body composition, adverse events. They ran random-effects meta-analyses reporting Hedges' g. Fourteen trials totaling 763 women across reproductive stages met the criteria — 5 on whole protein, 6 on amino acids, 3 on creatine.
§.02What the numbers actually show.
For the primary outcome (muscle mass), the combined intervention did not significantly beat exercise alone: g = 0.065 (95% CI: -0.353 to 0.482). The confidence interval crosses zero — the result is statistically indistinguishable from no effect.
The interesting subgroup finding was for the 3 creatine trials. Across those, the authors observed selective upper-body strength improvements when creatine was paired with resistance exercise. Effect was strongest for upper-body push/pull movements (bench, row, overhead press analogs), less clear for lower-body or bone outcomes.
Whole-protein and amino-acid supplementation showed no consistent additive benefit over exercise alone in this population — at the doses and durations studied.
§.03What it means if you are a woman over 40 considering creatine.
This is the most useful population-specific meta-analysis to date for creatine in women, especially around menopause. The conclusion is nuanced: it is not the silver bullet for total body composition that some social media has implied. But the strength signal — particularly upper-body — is real and consistent across the 3 trials.
For a woman in her 40s-60s considering creatine: the value is mainly to support strength outcomes from your training, not as a stand-alone for muscle mass or bone density. The protocol stays the same: 3-5 g/day of creatine monohydrate, ideally paired with resistance training 2-3x/week. Hydration goes up by about 500 mL/day.
For a woman who is not training: creatine alone is unlikely to do much. The benefit lives in the supplement-plus-exercise pairing.
§.04Limitations the authors flagged.
- Heterogeneity: 14 trials, multiple reproductive stages (pre/peri/postmenopausal), and three different supplement classes pooled together. Wide confidence intervals follow.
- Duration: most trials were under 12 months. For bone health endpoints, that is too short — bone turnover takes 6-18 months to remodel and the studies could not capture it.
- Site-specific bone measurements were inconsistent: some trials measured spine BMD, others hip, others whole-body. Pooling these dilutes the signal.
- Only 3 creatine trials: the subgroup-positive finding for upper-body strength is encouraging but rests on a small body of evidence. Future trials are needed to confirm.
§.05Where it fits in the broader evidence.
This meta-analysis is consistent with what the broader creatine literature shows: creatine works well for strength + power outcomes, less well for fat-free mass gains when not paired with progressive resistance training, and has limited direct effect on bone. The novelty here is the population — women across menopause, where most other meta-analyses have either excluded women or grouped them with older mixed-sex cohorts.
The Chilibeck et al. 2017 paper on creatine in older adults already pointed in the same direction. This 2026 update strengthens the case specifically for postmenopausal women adding creatine to a strength program. For protein and amino acids in this population, the case remains weaker — total daily protein matters more than supplement form.
§.99The bottom line.
If you are a woman around or past menopause and already strength-training: yes, add creatine monohydrate at 3-5 g/day. The evidence specifically for your demographic supports an upper-body strength benefit. If you are not training, supplements alone — creatine, protein, or amino acids — are not the move. Exercise remains the primary intervention. The meta-analysis is most useful as a reality check on supplement marketing aimed at midlife women: total daily protein matters, training matters, and creatine plays a supporting role rather than a starring one.
Creatine monohydrate, 500 g — at the apothecary.
§.RXThe study.
Chen KH, Yeh TP, Lin SC et al. — International journal of medical sciences, 2026 · DOI: 10.7150/ijms.130435
Reviewed by Dr. Marthe Janssen, PharmD on May 21, 2026. We summarize peer-reviewed research without making medical claims.
Disclaimer: this article is educational only and not medical advice. Statements about supplements have not been evaluated by the FDA. Always discuss new supplements with your prescriber.