Women & Creatine: Why is Everyone Talking About it and Do I Need it?

Confident woman doing a lunging exercise in a gym setting.

Bottom line up front: every adult benefits from taking creatine supplements, and for women in perimenopause, you get the double benefit of stronger muscles and a decrease in mood swings and mental fatigue!

The algorithms think I'm a 45 year old woman because of how much time I spend in this space discussing menopause. So, I know that your social media feed is filled with podcasts and clips of experts talking about creatine since May because MY feed has been filled with those same clips. But why now?

The reason is because of the great news we learned in May. For the previous 6 decades, all of the peer-reviewed research about creatine showed that it was great for men to build lean muscle mass. It is literally the single most-researched supplement in the world.

What we learned in May changed everything. For the first time, a peer-reviewed research paper was published showing what creatine does for women in perimenopause. Not only did the women in the study experience better muscle adaptations compared to men, but the participants said that they experienced fewer mood swings, better cognitive focus and literally an improved mood overall. When the women were sleep deprived, they reported that they felt significantly more focused when they supplemented their diet with creatine. [https://pubmed.ncbi.nlm.nih.gov/40371844/]

Why does muscle matter? Your body is already losing about 1% of its bone mineral density and its lean muscle mass per year, if you're just living your ordinary life. This puts women at higher risk of sarcopenia and osteoporosis, once you've lost significant muscle and your bones have weakened. You can control this loss and even reverse it with regular resistance training, e.g., lifting challenging weights. The creatine supplementation helps your muscles to have enough energy in them during those workouts, allowing you to create more lean, toned muscle and stay healthy.

Your body produces small amounts of creatine. That production and your normal omnivorous diet give you about 3 grams of creatine per day. If you are plant-based, you get significantly less creatine in your diet. You want to supplement at least 5 grams per day if you only want the physical benefits of creatine, and at least 10 to 20 grams per day if you also want the mood/cognitive benefits. 

Pro Tip: I've been using creatine since 1999. When purchasing it, get the plainest one that you can find: creatine monohydrate, with no other ingredients. It is so widely produced and so inexpensive, that most supplement companies add "proprietary" ingredients to justify charging you more. More is not better in this case. When you go to your favorite health food store and see the supplement aisle, the creatine products with added nonsense will be at eye-level, and they will cost at least $30-$40 per bottle. Look at the bottom shelf, directly under the flashy bottles. In every store, you will see the normal, unadulterated creatine for a fraction of the price in very plain, boring bottles. That is what you're looking for!

johnlewiscoach.com

The Ideal Workout Split for Women over 40 (Bookmark & Share This!)

Woman running up stadium stairs

Let's get right to it -- I'll start with the ideal training/workout split for women in perimenopause and post-menopause, and then I'll explain the science behind it and what the terms mean!

The Ideal Training Split for Women Over 40:

Day 1: Strength Training (Lower body)

Day 2: High-Intensity Interval Training (HIIT)/Sprint Interval Training (SIT) + Core (midsection) exercise

Day 3: Strength Training (Upper body)

Day 4: HIIT/SIT + Core exercise

Day 5: Total body Hypertrophy (muscle-building) exercise

Day 6: Low-Intensity/Steady-State (LISS) and/or deep stretching (yoga or other)

Day 7: Rest; nothing more intense than LISS and/or stretching

Ladies, this workout split address multiple needs that most of you have during peri- and post-menopause. The split ensures you: build lean muscle, reduce the size of your midsection, improve your flexibility/mobility, improve your bone mineral density (BMD), lose excess body fat, and improve your overall mood, your heart health and your cardiovascular capacity. Each one of those things leads to improved quality of life and a body that you can actually enjoy into old age.

Strength Training: This one is hugely important for strengthening your bones and contributes to new, functional muscle. Women in your stage are at increased risk of sarcopenia, osteopenia and osteoporosis; in other words, there's a higher likelihood that you will gradually lose useful muscle and lose bone mineral density every single year after 40. Many of you (unfortunately) probably know a woman in this stage who has fractured a hip or broken her wrist. Those are indicators of poor BMD, and among the nearly 300,000 women who wind up hospitalized from those fractures, some of them never get to go back home.

For a conventional strength training program, you want to do heavy compound lifts like squats and deadlifts to improve the BMD in your hips and spine, and do lifts like barbell rows and bench presses to improve the BMD in your arms and shoulders. After doing a warmup set, aim for 4 challenging repetitions for 4 sets, resting for at least 90 seconds between the sets. Select a slightly heavier weight for the same exercise each time you do your strength training. Do not allow fear to keep you lifting the same weight 3 weeks in a row. Challenge yourself-- that's when your bones and muscles grow.

HIIT/SIT training + Core: Start with 4 minutes of true Tabata training. The standard protocol is 20 seconds of sprint work at your top speed, like literal sprinting, cycling, or high knees in-place, followed by 10 seconds of rest, for 8 rounds. A more reasonable protocol for beginners and intermediates is 15 seconds of work followed by 45 seconds of rest. Start with 4 rounds, then progress to 8 rounds within 1 to 2 weeks. This improves your cardiovascular function and your VO2 max, a key marker for indicating your overall mortality. After completing your HIIT/SIT, cool down for 1 to 2 minutes, and begin 16 total minutes of core training. Russian twists, bicycle crunches, mountain climbers-- select core exercises that force you to rotate your midsection. Aim to do sets lasting 1 to 4 minutes, resting for 1 to 2 minutes between the sets, until you've completed 16 total minutes of core work. This is a little-known cheat code for targeting fat loss around your midsection. Researchers still don't fully understand the "why", or the mechanism behind why this works, but it's shown to be about 30% more effective at slimming your waistline than cardio alone.

Hypertrophy: This is resistance training to build lean new muscle and force your body to use more of her stored fat as fuel-- it's a win-win. The difference between doing hypertrophy training and strength training comes down to the number of repetitions per set and your intensity level. You should aim to be in the neighborhood of muscular failure at 12 repetitions per exercise, for 4 sets, within 1 to 2 minutes of rest between sets. The exercises themselves should target every major muscle group in your body (e.g., glutes, quadriceps, hamstrings, triceps, shoulders). For example, you choose to do goblet squats to train your quadriceps and glutes. After completing 12 repetitions, it should feel like you could do no more than 4 additional repetitions. Be honest with yourself. If you know you probably could have done 5 or more repetitions of at that weight, you need to select a heavier weight for your next set. This will take some guesswork-- nobody ever selects the ideal weight on their first attempt, so don't let fear prevent you from picking up a heavier weight, even if it's a weight that you've never lifted before.

LISS/Stretching: As an active recovery day, aim to do 40 minutes of casual walking at a moderate pace without taking a break. Alternatively take a deep-stretch yoga class for 30-50 minutes or spend that same amount of time stretching your muscles on your own. Aim to stretch your muscle bellies in a static hold for at least 30 to 45 seconds (e.g., standing toe reach to stretch your hamstrings and glutes).

These are general guidelines. If you aren't familiar with any of these forms of training, please work with a fitness professional before venturing out on your own. This protocol also assumes that the trainee is getting 0.8 grams of protein per pound of her body weight every day.

Crush your goals and reclaim your bodies, ladies! - John

References:

1. Sex Differences in Association of Physical Activity With All-Cause and Cardiovascular Mortality; Hongwei Ji MD ^{a ∗}, Martha Gulati MD, MS ^{b ∗}, Tzu Yu Huang MSc ^b, Alan C. Kwan MD ^b, David Ouyang MD ^b, Joseph E. Ebinger MD, MS ^b, Kaitlin Casaletto PhD ^c, Kerrie L. Moreau PhD ^{d e}, Hicham Skali MD, MSc ^f, Susan Cheng MD, MMSc, MPH ^b

2. Influence of exercise on mood in postmenopausal women; Carmen Villaverde Gutiérrez ¹, Gema Torres Luque, Gracia M Ábalos Medina, Maria J Argente del Castillo, Isabel M Guisado, Rafael Guisado Barrilao, Jesús Ramírez Rodrigo

3. The impact of physical activity and exercise interventions on symptoms for women experiencing menopause: overview of reviews; Annemarie Money ^1,2,✉, Aylish MacKenzie ^1,2, Gill Norman ⁴, Charlotte Eost-Telling ^1,2, Danielle Harris ^1,2, Jane McDermott ², Chris Todd ^1,2,3

Please Get Off of Your Knees.

A woman executing a push up or press-up.

Pushups! Nothing gets the job done quite like a pushup.

We're talking about an exercise that requires zero equipment, yet challenges our chest, triceps, shoulders and core muscles in a way that no other exercise can. Almost every culture in the world uses traditional pushups as a way to assess upper body muscular endurance, and for good reason. It's also great for causing hypertrophy, aka creating lean muscle tissue.

Pushups are challenging, and that's what makes them such a great exercise. Every able-bodied person should be able to complete at least a dozen pushups within a minute. People sometimes try and fail to complete a few pushups, and then decide (or are coached) to do the pushups on their knees. This can be good for teaching the person what it feels like to have flexion in their elbows. It can also teach them what it feels like to support their upper body with their triceps, and it can build some muscular endurance in the triceps as well.

However, knee pushups are an entirely differently exercise to pushups. The trainee does not have to support a significant portion of their bodyweight. With their knees on the ground, the trainee cannot fully engage all of their front core muscles, aka their anterior chain. What ends up happening is trainees will do several dozen knee pushups -- sometimes 30 or more repetitions, but still cannot complete a handful of real pushups. That's because there is no actual progression between the two exercises. The most direct way to get better at pushups is to execute pushups.

The most important element is learning to support yourself in a plank position with the arms extended. Individuals who struggle to maintain a straight spine and midsection in that plank position will struggle to complete a pushup. The struggle has nothing to do with their triceps and chest if they are able to complete several dozen knee pushups. The struggle is actually their core strength and core endurance. Specifically, the trainee typically has weakness in their transverse abdominus, or the lower part of their torso. That portion of their core is being asked to support the weight of their lower body, and that's what presents their greatest challenge in completing the pushup.

One way to get a stronger core for pushups is to start with your body flat on the ground, and learn to contract your core from there. Now, think of your core as every single muscle between your armpits to your knee pits. They all work in unison to stabilize your body in many positions. Squeeze your inner thighs together slightly. Feel your glutes contract. Use your midsection muscle to tighten up, as you imagine your muscles contracting like the wringing of a towel. Contract the upper back muscles, as you feel your shoulder blades shifting down into a locked position. Then, you can place your hands just outside of shoulder width and press yourself up until your arms are locked out. Maintain that tension on your entire core, then lower yourself back to the ground and relax. Reset and try again. This variation of pushup, sometimes called floor pushups, will directly lead to you being able to do real pushups!

Another variation for getting better pushups is to do partial pushups. Start in the upright plank position, arms fully extended. Tighten all of your core muscles, as you did in the floor pushups. Start from your legs and work your way up to your back and chest. Maintain that core tightness, and then bend your elbows to lower yourself as low as you can comfortably go. Don't be afraid of falling! Then press yourself back up to the upright plank position. Aim to do 12 partial pushups at a time. Every 3 to four days, try again. You can even use your phone to record yourself and see how low you're going. Go lower and lower until those partial pushups because full pullups!