Creatine and Brain Fog in Perimenopause: What the Science Actually Says

Creatine perimenopause brain fog is one of the most searched supplement topics in the menopause space right now. Coach Catharine here, and I wanted to touch on something I get asked a lot with clients, and it comes up here too! Creatine for perimenopause. What does it really do, and can it help with brain fog? Here's what we actually know. Spoiler: the connection between this supplement and midlife cognitive fog is a lot weaker than social media would have you believe.

So, you know that moment when you're mid-sentence and the word you need just… vanishes?

Or when you walk into a room with purpose and then stand there, completely blank, wondering what on earth you came for?

Or when you read the same paragraph three times and it still hasn't landed?

If you've been there, I want you to know: you're not losing it. You're not alone. And you're definitely not imagining this.

So many women in this life stage describe their brain as feeling "offline", foggy, unreliable, like it's just not firing the way it used to. It's unsettling and frustrating. And of course you want to find something, anything, to help.

One supplement that keeps coming up in conversations about brain health is creatine. You probably know it as a strength and muscle-building supplement, but lately it's being talked about for cognitive support too. You've probably seen influencers and even some doctors making confident claims about it clearing the fog, boosting mood, and protecting your brain during menopause.

So naturally, the question becomes: Could this supplement actually help with the foggy thinking so many of us deal with?

It's a really smart, logical question. I'm not calling anyone out specifically here. A lot of people in this space are making these claims, some of them doctors with big platforms. The problem isn't one person, it's a pattern of stretching early research into confident recommendations. I want to break down what we actually know, and where the gaps are.

What Is Creatine, and Why Are We Even Talking About It?

Creatine is a compound your body makes naturally, and you also get it from food, especially meat and fish. It plays a key role in energy production, particularly in tissues that need a lot of energy... like your muscles and your brain.

Most of us have heard about creatine in the context of sports performance, building strength and supporting muscle mass. But over the past decade or so, researchers have started looking at whether it might also support:

• Cognitive function (memory, attention, thinking speed)
• Neurological health
• Healthy aging

So the thinking goes: If creatine helps fuel the brain's energy systems, maybe it could help with the mental fog that comes with this life stage?

It makes sense on paper. Let's see what the research actually says.

The Hard Truth About Creatine and Perimenopause Brain Fog

The most important thing I need to tell you up front:

We currently have no direct clinical trials testing creatine's cognitive effects specifically in perimenopausal women.

None.

A recent systematic review that searched through over a thousand research papers found:

• No randomized controlled trials
• No observational studies

that looked at supplementation and cognitive outcomes in perimenopausal women as a specific group.^[3]

What that means in plain language:

• We do not have research showing that this supplement improves foggy thinking, memory, or attention during the menopausal transition.
• Any claims that it's a proven "cognitive booster" for midlife women are getting ahead of what the science actually supports right now.

I know that's probably not the answer you were hoping for. But I'd rather give you the honest truth than overpromise something that isn't backed up yet.

What About That New Study You May Have Seen?

In 2025, one small trial (called CONCRET-MENOPA) did test the supplement in 36 perimenopausal and menopausal women over 8 weeks and found some improvements in reaction time and brain creatine levels.^[22] That sounds promising on the surface, but there are important caveats:

• 36 women for 8 weeks. That is a very small, very short study. It is not enough to draw confident conclusions from.
• They didn't use creatine monohydrate. The study used creatine hydrochloride and creatine ethyl ester, which are NOT the form used in virtually all the research that supports creatine's benefits. Research has actually shown that creatine ethyl ester is less effective than monohydrate at raising muscle creatine levels and doesn't outperform placebo for body composition or strength.^[23]
• Low-dose formulations rather than the standard 3 to 5 g/day protocol that most of the evidence base is built on.

So while it's encouraging that researchers are finally studying this population directly, the results from one tiny trial using a different form of creatine at different doses cannot be generalized. We need larger, longer trials using creatine monohydrate before we can say anything with confidence.

What We Know from Other Groups of People

Because we don't have studies in perimenopausal women specifically, most of what we're working with comes from research in:

• Older adults (usually 55+)
• Mixed groups of men and women
• Some studies in women, but not defined by menopausal status

Those studies suggest:

Small, Task-Specific Benefits in Older Adults

Systematic reviews and meta-analyses in older adults have found that supplementation or higher dietary intake of this compound is associated with small improvements in certain types of memory and attention.^[2][3][4]

But, and this is important, not all studies show benefits. The effects tend to be modest and specific to particular cognitive tasks, not dramatic across-the-board improvements.

These Aren't Perimenopause Studies

The catch is, these studies are usually in healthy, community-dwelling older adults, groups that aren't focused on midlife hormonal transition. Sometimes mixed men and women, without separating results by sex or menopausal stage.

So while the findings are interesting, we can't automatically assume they'll apply to women in their 40s and early 50s who are experiencing the wild hormonal fluctuations of perimenopause. It's a different life stage, a different hormonal context.

Women Don't Seem to Respond Differently Than Men (So Far)

Some researchers have asked: Do women benefit more than men from creatine for cognitive function?

So far, the meta-analyses don't show a strong, consistent difference. In other words, women don't clearly emerge as uniquely responsive to the supplement when it comes to thinking skills.^[4][21]

So Where Does This Leave Us?

Right now, the most accurate picture I can give you:

If you're thinking about taking this supplement purely to "fix" foggy thinking in midlife, the science just isn't there yet to support that promise.

That doesn't mean creatine is harmful. But it does mean it shouldn't be marketed to you as an evidence-based cognitive solution for this life stage. Any benefits you might notice are currently in the "possible but unproven" category for cognition in this context.

What Does Help Brain Health in Perimenopause?

Even though the research on this supplement is limited for our life stage, we do have stronger evidence for other strategies that support cognitive function and long-term brain health in women around menopause.

1. Regular Physical Activity

Aerobic exercise and resistance training are consistently linked with better cognitive function in older adults and women in midlife.^[18] Exercise supports blood flow to the brain, brain plasticity, and mood and sleep, which indirectly but powerfully influence how sharp you feel day to day.

2. Staying Mentally and Socially Engaged

Studies link active social networks and mentally stimulating activities, learning new things, problem-solving, complex work or hobbies, with a reduced risk of cognitive decline and dementia over time.^[19][20]

Keeping your brain challenged and staying connected to people around you goes a long way.

3. Nutrition Patterns, Not Magic Pills

Mediterranean-style eating patterns and omega-3 rich foods are consistently associated with better cognitive outcomes in older adults.^[16][17]

Meanwhile, trials of many vitamins and dietary supplements (like vitamin B12 in people who aren't deficient) have generally not shown meaningful cognitive benefits.

Real food beats pills, again and again.

Interestingly, if you're curious about a supplement with actual cognitive evidence in menopausal women, resveratrol (a compound found in red grapes, berries, and peanuts) has the strongest track record so far. Multiple randomized controlled trials have found that resveratrol supplementation improves overall cognitive performance, verbal memory, and blood flow to the brain in postmenopausal women.^[24] It's not a miracle pill either, but the evidence is significantly stronger than what exists for creatine in this context. As always, talk with your healthcare provider before starting any supplement.

4. Addressing Sleep, Mood, and Hot Flashes

Perimenopause can bring brutal insomnia and those 3 AM wide-awake sessions, anxiety or low mood that feel like they came out of nowhere, and hot flashes and night sweats that are really distressing.

These don't explain everything about foggy thinking, but they're strongly related to how your thinking feels day to day. Supporting your sleep, mood, and vasomotor symptoms, through evidence-based lifestyle changes and, when appropriate, medical treatment, can help your cognitive function feel more stable.

Is Creatine Ever Worth Considering?

For some women, the supplement might still make sense, but the primary reason would usually be supporting muscle strength, maintaining lean mass, and possibly improving performance in resistance training.

If you're already using creatine for those reasons and you're curious about any subtle changes in mental clarity, you could track it:

• Keep a simple log of sleep quality, mood, perceived cognitive fog, and training recovery
• Look for patterns over several weeks
• Stay honest that any changes might not be directly caused by the supplement

And before starting any supplement, especially if you have kidney disease, high blood pressure, or take multiple medications, please talk with your healthcare provider. I'm here to educate and share what the research says, but your doctor is the one who can help you decide what's right for your specific situation.

ONE Thing You Can Do This Week

You're Not Broken

If your brain feels different in perimenopause, I need you to hear this: you are not imagining it, and you are not failing.

Cognitive changes around this transition are real and recognised in the research, even though we still have so many unanswered questions.

Your body is going through a massive hormonal shift right now, and your brain is adjusting along with it. You deserve information that's honest and evidence-based. Not hype. Not empty promises.

If you have questions or want to talk about what might actually help in your specific situation, I'm here. That's what I do, help women make sense of what's happening in their bodies and build practical, personalised plans that actually fit real life.

You don't have to figure this out alone, and you're doing better than you think.

Coach Catharine 🩷

A Quick Note on Supplement Claims and Conflicts of Interest

One thing I want you to be aware of as you move through the menopause wellness space: be cautious when the same influencer claiming a supplement has life-changing benefits is also selling that supplement. This is a pattern we see over and over again. Doctors and influencers with large platforms making confident claims about creatine (or any supplement) for menopause, while simultaneously running supplement companies and profiting from those exact products.

That doesn't automatically mean the science is wrong. But it does mean you should ask: Is this person educating me, or selling to me? When someone has a financial stake in you buying a product, the way they present the research can shift. Positive studies get highlighted. Limitations get left out. "Promising but early" becomes "proven and essential."

Look for people who will tell you what the evidence actually says, including the gaps, even when it's not the answer you were hoping for. If someone is willing to say "we don't know yet" instead of "buy this," that's a good sign.

Common Meno-Influencer Creatine Claims vs. What the Evidence Actually Shows