Effects of creatine and resistance training on bone health in postmenopausal women

By Bhavana Sachdev, M.S.

Calcium and phosphates are the two essentials minerals needed to keep our bones healthy. During our lives body continuously is in process of forming new bones and reabsorbing old ones therefore there is a need to build a proper balance in building and degradation of bones to keep them healthy and strong. In the absence of the body’s ability to maintain this balance there occurs bone loss in the body, as the rate of degradation of old bones is more as compared to formation of new bones.

With aging the bone mass or density decreases as body re absorbs calcium and phosphates from the bones, which results in scarcity of these minerals in the bones making them weak. If this process continues it leads to Osteoporosis in women as well as in men. Women with menopause or above 50 yrs of age suffer from bone loss due to dip in estrogen level after menopause and men above 70 yrs of age suffer this due to dip in testosterone level in the body. It results in Inflammation, Pain, Loss of strength, Brittleness of bones, Compression fractures as bones may break easily, Stiffness, Fatigue, Weakness and Loss of balance.

Strength training given to women prevents bone loss and helps building new bones especially in older women suffering from osteoporosis. Weight training helps maintaining strong muscles, which helps in balancing the weight of the body properly preventing osteoporosis related fractures of the bones especially of the back and the hip.


Creatine is a naturally occurring nitrogenous organic acid found in the body especially in the muscles and made up of three amino acids Glycine, methionine and arginine. It helps in supplying energy to all cells of the body by producing ATP.


1-2mg of creatine is made by the body everyday and out of that about 95% of that creatine is located in the skeletal muscles of the body and rest in other parts including brain and retina. Certain foods like meat and fish as well some supplements are good source of creatine.


As it is a very useful compound for supplying energy in the body whenever it is demanded, therefore it is used by athletes for improving exercise performance during high intensity workouts and during trainings by increasing muscle mass and strength. It also reduces fatigue, improves recovery and helps in gaining lean muscle mass impacting overall performance of the athlete. Apart from this it is also helpful in treating many diseases like high cholesterol, Parkinson’s disease, depression, arthritis, muscular dystrophies and heart failure.


It works by providing phosphate to an ADP molecule, which results in production of ATP which is a primary source of energy. Therefore supplementation with creatine increases its levels in the muscles as a result of which phosphate is easily available in the muscles to form and use ATP when required during high intensity workouts.


With Aging bones become weak and muscle mass decreases which affect daily routine tasks as well as can cause fracture even by a light or mild stress on the brittle bones which can result in permanent disability and even premature death. These Osteoporosis related fractures occur mainly in the hips, spine or the wrist areas. Post menopausal women are at high risk of developing this due to a dip in estrogen level after menopause as well as due to calcium and mineral loss in the body. The vertebrae bones, which make the spine, become thinner due to fluid loss and spine becomes curved and compressed. The bones which form the arms and the legs become brittle due to mineral loss and look long, joints become stiffer and loses flexibility due to decrease in fluid in the joints. Hip and knee joints begin to lose joint cartilage. Lean body mass decreases, that is caused in part by loss of muscle tissue. Therefore some lifestyle changes are suggested for the prevention of osteoporosis in postmenopausal women, which includes exercise training, which has shown beneficial effects on bone but less as compared to combining exercise training along with creatine.

In several studies creatine has shown positive effects by providing required energy during high intensity workouts as well as on post menopausal women during short term exercise. Therefore its effect was seen if given for long time in postmenopausal women.


A study was carried to evaluate the safety and efficacy of creatine Supplementation on muscle performance and on properties of bone when given for long time approx 12 months in postmenopausal women undergoing exercise training.

47 eligible postmenopausal women were randomized to receive either creatine or placebo immediately before and after the resistance training exercise three times a week. creatine was given at a dose of 0.1g·kg-1·d-1 (0.05g·kg-1 before and 0.05g·kg-1 after the exercise or training session three times a week and with two meals on rest of the days i.e. non-training days).

Exercises included hack squat, adduction, hip abduction, flexion, hamstrings curl, quadriceps (knee) extension, bench press, shoulder press, biceps curl, wrist pronation, ankle dorsi-flexion and plantar flexion. Three sets of 10 repetitions were performed and Intensity was increased progressively on an individual basis. Primary outcome of this study was lumbar spine BMD measurement and femoral neck BMD as these sites were considered to be most responsive to the effect of exercise training.

BMD and other measurements were associated with fracture risk in these patients therefore these were carefully calculated along with measurement of elbow, knee, ankle flexor and extensor muscle thickness, changes in hip structural analyses and bone ultrasound measures along with lean tissue mass, muscle thickness measures, strength or training volume. The results showed that creatine given for 12 months in postmenopausal women during a resistance training program preserved bone mineral density at the femoral neck which is very important as osteoporotic fracture has a very deleterious effect on the femoral neck.

The women in the creatine group lost only 1.2% of BMD as compared to 3.9% in the placebo group. It also increased bending strength of the bone in these women, which led to increase in upper body strength. Although the effect on muscles mass and strength was small in bench press strength in creatine group with as compared to placebo group. There were favorable changes shown in the strength and lean tissue mass for the creatine group. Only mild to moderate adverse events were observed without any in effectiveness to perform daily activities. Overall it was effective in preserving BMD at the femoral neck along with increase in the sub periosteal width of the femoral shaft and ultimately greater bone bending strength.

Creatine supplementation increased the ability to synthesize ATP and hence increased training capacity along with muscle mass, which results in increased capacity to resist strain on the bone and hence bone formation, which further increases the bone mineral content.

Summarized from the article:


Philip D. Chilibeck, Darren G. Candow, Tim Landeryou, Mojtaba Kaviani, and Lisa Paus-Jenssen

Medicine & Science in Sports & Exercise, Publish Ahead of Print

DOI: 10.1249/MSS.0000000000000571