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Stronger Through the Transition: Evaluating the Effect of Creatine and Resistance Training on Body Composition, Strength, and Sleep in Perimenopause

Delbiondo GM, Baker PA, Johnson WM, Kelly CG, Gottlieb CW, Grosicki GJ et al. · Preprints.org · 2026

This study examined whether adding creatine monohydrate to six weeks of high-intensity resistance training improved body composition, muscle size, strength, and sleep in perimenopausal women compared to placebo or no training. Resistance training increased strength and muscle size in all trained groups, with creatine providing additional gains in lean tissue mass and slightly larger increases in muscle size compared to placebo, though sleep was not meaningfully affected by any treatment.
Takeaway: Include resistance training in your routine during perimenopause, and consider creatine supplementation if you want to maximize gains in lean muscle mass and strength.
Abstract (source)

Introduction: Perimenopause is associated with adverse body composition and strength changes, yet resistance training and creatine monohydrate (CM) remain underrepresented in this population. This study examined the effect of six-weeks of high-intensity resistance training (HIRT) with or without CM on body composition, muscle size and quality, strength, volume, and sleep in perimenopause.

Methods: Fifty-one perimenopausal women (Age: 46.2±4.6 years; Body Mass Index: 25.4±4.0 kg/m2) were randomized to CM, placebo (PL), or control (CON). CM and PL completed a 5-day loading (CM: 20g/day; non-caloric PL: 14.5g/day), followed by a maintenance phase (CM 4.5g/day; PL gummies) combined with six-weeks of HIRT; CON maintained normal activity. Lean soft-tissue (LST; kg) was assessed from dual-energy x-ray absorptiometry. Muscle characteristics were determined from peripheral quantitative computed-tomography [muscle area (MuA); cm2; muscle density (MuD); mg/cm3]; and ultrasound [muscle cross-sectional area (mCSA): cm2; echo intensity (EI): a.u.]. Sleep was determined from a wrist-worn wearable.

Results: CM resulted in increased LST compared to PL (mean difference±standard error: 0.380±0.431 kg, p=0.999) and CON (1.052±0.474 kg, p=0.096). Muscle size increased in CM compared to CON (MuA: 6.11±2.19 cm2; mCSA: 3.222±1.051 cm2; p=0.011-0.023), but not PL. No main treatment effects were observed for MuD or EI. Both lower (CM: 139.6±34.1 lbs; PL: 126.2±31.5 lbs; p< 0.001) and upper body (CM: 9.0±3.4 lbs; p=0.031; PL: 8.1±3.0 lbs; p=0.032) strength increased compared to CON, with no volume differences. No training by treatment interactions were observed for sleep.

Conclusion: HIRT improved muscle outcomes, with CM adding 0.38 kg to LST and 148.6 lbs to strength.

Randomized controlled trialSports Nutrition & Supplements
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