For many women in midlife, creatine still sits in the mental category of “not for us”, something associated with bodybuilding culture, gym bros, and extreme fitness goals. Yet quietly, the science has been telling a very different story. In this conversation, I speak with Shelley Balls, Registered Dietitian Nutritionist at Flawless Bloom, who brings clarity, evidence, and practicality to a supplement that deserves a second look. Practising in rural Wyoming, Shelley understands the realities of women who want to age well without access to endless specialists or complicated protocols. With a calm, science-backed approach, she explains how creatine supports muscle, energy, cognition, and long-term resilience, not as a trend, but as a tool for everyday wellbeing in midlife.

Creatine has long been associated with young men and gym culture. Why do you think midlife women were left out of the conversation for so long, and what’s shifting now?

I honestly think a lot of the reason why midlife women were left out of the conversation was that most studies and marketing were geared towards young men and those within the gym culture. However, as more research has come out showing not only physical benefits but also mental things are starting to shift. Creatine is not only found in muscles but also in the brain, making it a nutrient everyone should be getting adequate amounts of! Every year, more evidence emerges showing the many health benefits of creatine, including those of cognitive health, which I think has really helped increase the popularity of creatine because we all can benefit from it.

As women move through perimenopause and menopause, muscle loss accelerates. From a clinical perspective, how does creatine support muscle health, strength, and physical resilience during this stage?

Creatine can be especially important for women in their midlife, as this time is when we naturally see a drop in estrogen levels, which can increase the loss of lean mass, so ensuring adequate protein intake, paired with strength training at least two days per week can help decrease muscle loss! During menopause, it’s common to lose both muscle mass and bone mass due to estrogen levels dropping. Having less muscle and bone mass decreases your metabolism, making weight gain easier. Adding strength training to your routine is an effective way to counteract age and menopause-related muscle and bone loss and help build strength to help prevent falls and injuries as we age. Ensuring adequate protein intake and pairing this with a strength training regimen can help maintain a healthy metabolic rate and promote overall health as you age. For women in their midlife, I recommend supplementing with creatine at 3–5 grams per day.

Many women notice drops in energy, stamina, and recovery in midlife. What does the evidence say about creatine’s role in cellular energy and day-to-day vitality for women?

Creatine supplementation supports ATP recycling, and ATP is your body’s energy source. So creatine can help you perform your best during demanding activities, and that includes mentally at work. Creatine can help you feel more like your younger self by improving your stamina.

Beyond muscles, research is increasingly pointing to creatine’s impact on the brain. How might creatine support cognitive function, brain fog, or mental fatigue in menopause?

Creatine has been shown to promote brain and nerve health, including improved cognitive function, which, as we age, can be very helpful. Creatine has also been shown to work as a stress buffer, stabilising energy levels, preventing brain fog and mental fatigue.

Some women are understandably cautious about supplements. How do you help patients distinguish between evidence-based supplements like creatine and those driven more by marketing than science?

I often share with clients that creatine is one of the most widely researched supplements on the market, and it’s been found to be safe to use short-term and long-term at any age. I also recommend that clients look for third-party tested products to ensure safety and purity, since the FDA does not regulate supplements. Some supplement companies use a lot of fillers and don’t get their supplements third-party tested, so you could be spending money on a product that doesn’t actually contain what it says it does. When buying supplements, always look for ones that are third-party tested for purity and safety, such as USP Verified or NSF Certified for Sport. I consume Thorne NSF Certified for Sport creatine myself.

Are there specific life stages or symptom profiles where you’ve seen creatine be particularly helpful for women, for example, during perimenopause, postmenopause, or alongside HRT?

When your hormones are working against you during perimenopause and menopause, having a supplement to help fight with you to retain muscle, strength, and cognition can be particularly helpful.

Dosage and safety are common concerns. What do women in midlife need to know about using creatine safely, especially those with medical conditions or who are on hormone therapy?

It’s recommended that individuals consume 5 grams of creatine per day to see positive effects. As a dietitian, I am all about getting most nutrients from food alone, and supplementing when needed, but optimal creatine levels are hard to achieve with diet alone. To consume 5 grams of creatine, you’d have to consume approximately 2.2 pounds of beef steak or salmon every day, which is just unrealistic. Animal products (beef, chicken, fish, pork) are the main dietary sources of creatine, but the amount of creatine found in them is small once cooked, making it hard to consume adequate amounts with just diet alone.

Talk to your doctor before taking creatine if you are pregnant, breast-feeding, have heart conditions, kidney or liver disease to ensure it’s safe for you to take.

Many midlife women are not lifting heavy weights or doing intense workouts. Is creatine still beneficial without high-intensity training, and if so, how?

Creatine isn’t just for athletes; with its cognitive benefits, almost everyone could benefit from it, and it helps boost overall protein intake. I would still recommend that you obtain at least two days of strength training in your weekly routine in order to promote overall health and healthy ageing.

You practise in a rural setting where access to specialist care can be limited. How do practical, affordable tools like creatine help level the playing field for women’s health and longevity?

I live in Wyoming, so I know rural areas and understand that access to specialists can be limited. Creatine is an affordable, yet widely accessible choice when it comes to promoting your health and longevity. Here are some of my favourite ways to add it into my routine:

• Mix creatine into fruit smoothies with Greek yoghurt, berries, a banana, and spinach. Smoothies are so versatile when it comes to add-ins, making them a perfect option for mixing in creatine.
• Mix creatine into fruit parfaits with Greek yoghurt, granola, and fresh berries. This nutrient-dense, crunchy treat provides a great grab-and-go option that you can easily mix in some creatine.
• Blend into your post-workout recovery drinks, such as chocolate milk, or your recovery shake. The creamy texture of the chocolate milk blends well with creatine!
• Mix into beef tacos at the end of the cooking process. The creatine will stick to the meat, making for a meal packed with creatine!
• Sprinkle over your scrambled eggs at the end of the cooking process. Scrambled eggs are very versatile; you can add creatine, chopped spinach, sliced grape tomatoes, and more for a delicious and nutrient-packed breakfast!
• Mix creatine into your overnight oats for a convenient and easy grab-and-go breakfast or snack!
• Mix it into fruit juice, especially great post-workout to help you replenish glycogen stores and boost creatine intake.

If you could reframe creatine for midlife women in one sentence, moving it from “not for us” to something empowering and supportive, what would you want women to understand?

As a dietitian, there are only a few supplements I truly recommend, and creatine is one of them to help empower and support midlife women.

What stands out most from Shelley’s perspective is reassurance. Creatine isn’t about chasing youth or pushing harder; it’s about supporting the body you’re in now. As estrogen declines and the demands of life remain high, midlife women deserve tools that work with them, not against them. Creatine, when used thoughtfully and safely, becomes less about performance and more about preservation: of strength, clarity, stamina, and confidence. Perhaps the most important reframe is this: supporting your muscles and brain in midlife isn’t indulgent or excessive, it’s foundational. And as Shelley reminds us, sometimes the most empowering choices are also the simplest ones.

If my words have helped you, a small contribution here will allow them to continue reaching the women who need them most. Also, don't forget to join me on Substack, where I share my Love Notes, a gentle pause in your week to reflect, realign, and reconnect in midlife. It’s not just another newsletter; it’s an intimate circle where I offer fresh intentions, soulful prompts, and simple but powerful shifts to inspire purposeful, creative living. Together, we’ll uncover the small but meaningful changes that help you design a life that feels beautifully your own.