Exercise alone provides the most reliable benefit for musculoskeletal health in women across reproductive stages, and nutritional supplementation does not consistently enhance muscle mass, bone health, or lower-body strength outcomes, despite selective improvements in upper-body strength with creatine.

When muscles contract during exercise, they pull on bones and trigger signals that build stronger bones and muscles. Women's bodies respond to this physical stress by making muscle and bone tissue stronger, no matter their reproductive stage. Supplements like protein or creatine do not consistently make muscles or bones stronger because the body's ability to use them is blocked by hormonal changes, especially after menopause, when inflammation rises and muscle-building signals weaken. Creatine only improves upper-body strength because it helps muscles produce energy faster during short bursts, and women's upper-body muscles start with less of this energy reserve than men's.