This analysis combined data from six randomized trials involving 608 postmenopausal women aged 40 to 45 years. Participants received creatine monohydrate with or without resistance training, or a placebo. The studies lasted between 12 and 104 weeks, with a median follow-up of 38 weeks. Researchers measured lean mass, strength, bone density, and physical function.
The results showed that creatine supplementation increased lean mass by an average of 0.37 kilograms compared to placebo. When combined with resistance training, leg-press strength improved by an average of 7.5 kilograms. Bone mineral density remained unchanged overall.
Safety was assessed by looking at kidney function and adverse events. No serious side effects were reported, and kidney markers stayed the same. Most adverse events were mild and similar to those seen in the placebo group. No participants stopped the study due to safety concerns.
The review noted some concerns about bias in most of the included studies. Only one large trial was rated as having low risk of bias. The review itself was not registered before the analysis began. Readers should understand that effects on bone density remain unclear and that the overall certainty of the evidence is limited.