Hello everyone,
Happy Sunday! I had an incredibly hard week with numerous social events crammed into 7 days. After working from home for 2 years, I find myself extremely drained by constant social interaction.
Today, we discuss Creatine. I was on a trip recently, and I was telling someone I have PCOS. She immediately started telling me about Creatine and how it can “balance hormones”. I am always amazed at how quickly people jump to giving health advice without any prior knowledge of your condition, background, or who you are. Whilst she was well-intentioned, as she was a lovely person, this is what is wrong with the wellness industry.
Please don’t take things, especially pills, based on someone’s random advice - supplements, like medication, have side effects.
Don’t give unsolicited advice to someone who has not asked for it. I never tell people I am a nutritionist unless they ask, and they are openly asking for help or advice - we don’t know what stage of their life they are at.
Nevertheless, let’s see if there is some truth to this advice.
What is creatine?
Creatine is a substance produced in the liver, kidneys, and pancreas from the amino acids glycine, arginine, and methionine. It is also found in animal-based foods. It is stored in the muscles, mainly as phosphocreatine, and serves as a crucial, rapidly available energy source during high-intensity, short-duration activities.
It’s a very popular supplement among those who lift heavy weights because it increases muscle strength. You are essentially giving it more food, allowing you to lift heavier and go for longer. It also facilitates a quicker recovery, as the energy storage is replenished quickly.
Does it have any usefulness for our hormones?
First and foremost, the research done on females is scarce. Are you shocked?
What we know is that females can display up to 70%-80% less creatine than males. It makes sense, given that males have bigger muscles and, from an evolutionary perspective, had to use their muscles much more.
Additionally, estrogen and progesterone influence the conversion of creatine. This finding was observed in animal studies, not human studies. Maybe this can partially explain why I can easily squat with 24kg in my follicular phase and only 12kg in my luteal phase. Due to this reason, a few studies suggest that females with varying levels of training and fitness may experience improvements in both anaerobic and aerobic exercise performance from both short-term and long-term creatine supplementation.
When it comes to balancing our hormones, or any link, there is none. Currently, there is no research investigating the impact of creatine supplementation on hormones.
A small study found that inadequate dietary creatine intake less than ~13 mg per kg of body weight per day) was associated with irregular periods. However, his evidence is associational; it shows a correlation in dietary survey data, not proof that low creatine directly causes these problems. I wouldn’t take this seriously.
So, no, you should not take creatine to regulate your hormones. However, you can take it for your sports performance. You could argue that better muscle mass would equal less insulin resistance, but I think getting in a good workout routine is where we should focus our attention.
There is some interesting association between creatine and mental health. Given women with PCOS have a higher risk of anxiety and depression, this might be worth paying attention to 👇🏼.
Creatine, mood and sleep
Creatine also helps the brain to produce and recycle energy quickly, which is especially important for neurotransmitters like serotonin and dopamine that influence mood. In people with depression, particularly women, the brain often shows signs of “low energy,” with reduced creatine and phosphocreatine levels. Since women naturally have slightly lower brain creatine, this may partly explain why they experience depression at higher rates during times of hormonal change (puberty, postpartum, menopause). By boosting brain energy, creatine seems to make antidepressants work faster and more effectively, with studies showing significant drops in depression scores when creatine is added to treatment. Extensive population studies also suggest that people with the lowest dietary creatine intake are more likely to experience depression.
When it comes to thinking and sleep, creatine provides extra “fuel” for the brain during mentally demanding tasks or when you’re running on little sleep. Research shows that creatine supplementation improves memory, attention, and mental stamina in healthy adults, vegetarians (who typically have lower creatine levels), and individuals with cognitive difficulties. Women often face unique stress on their brains, like multitasking, sleep loss during pregnancy or postpartum, or menopause-related sleep problems. These are the situations where creatine has been proven to be beneficial. It buffers the energy dip that comes with fatigue or low estrogen phases of the cycle, making it easier to stay alert, think clearly, and bounce back from stress. In short, creatine acts like an energy stabiliser for the brain, supporting both mood and mental performance when demands are high or energy is low. Looking back at the conversation with my friend, this is what she was referring to. She associated hormonal imbalance = mood swings and focus issues = and creatine helps. She didn’t mean hormonal imbalance = PCOS = creatine helps.
Overall, Creatine is not a supplement that should be on our radar for PCOS specifically.
See you next Sunday,
Francesca
Ellery, S.J., Walker, D.W. & Dickinson, H. (2016) Creatine for women: a review of the relationship between creatine and the reproductive cycle and female-specific benefits of creatine therapy. Amino Acids, 48(8), pp. 1807–1817. doi:10.1007/s00726-016-2199-y.
Smith-Ryan, A.E., Cabre, H.E., Eckerson, J.M. & Candow, D.G. (2021) ‘Creatine Supplementation in Women’s Health: A Lifespan Perspective’, Nutrients, 13(3), p. 877. doi:10.3390/nu13030877.
Smith-Ryan, A.E., DelBiondo, G.M., Brown, A.F., Kleiner, S.M., Tran, N.T. & Ellery, S.J. (2025) Creatine in women’s health: bridging the gap from menstruation through pregnancy to menopause. Journal of the International Society of Sports Nutrition, 22(1), 2502094. doi:10.1080/15502783.2025.2502094.