Creatine Use Among Women Across Reported Duration-of-Use Groups: A Platform-Based Cross-Sectional Survey of...

Creatine is now discussed beyond sports performance and within women's health, cognition, fatigue, and healthy-aging contexts. However, little is known about the characteristics of women who use creatine or whether these characteristics differ across durations of use. This study characterized women reporting current or past-12-month creatine use in a large cross-sectional sample and benchmarked findings against men.

In a cross-sectional, supplement-platform convenience survey (approximately 2.0% response rate; a secondary analysis of a previously reported cohort), 2094 current or recent creatine users (1055 women, 1039 men; mean age 53 years [54.0 in women and 52.5 in men]) reported duration of use, supplementation goals, information sources, creatine knowledge alignment using a five-item battery, self-rated confidence, satisfaction, and intent to continue supplementation for another six months. Representation of women across six ordered duration bands was evaluated using an age-adjusted logistic model with duration as a categorical factor, with a Cochran-Armitage trend test reported alongside it. Among women, goals and information sources were compared across duration-of-use bands using unadjusted tests of homogeneity, and knowledge alignment was evaluated using an ordered trend test. Gender differences were estimated in age- and duration-adjusted models, pooled across duration groups, with Benjamini-Hochberg correction within domain; gender × duration interactions were tested for the goal and information-source outcomes. Self-rated confidence was modeled as a function of knowledge, gender, and their interaction.

Women comprised 50.0-63.9% of respondents across each reported duration category below three years but only 19.7% of those reporting 3+ years of use. In the primary age-adjusted analysis, gender composition differed strongly across duration categories (global p < 0.001); relative to the 3+ year group, the odds of identifying as a woman were 3.9- to 7.5-fold higher in every shorter-duration category. Among women, knowledge alignment was higher at longer reported durations in the unadjusted analysis and remained associated with duration after adjustment for age, BMI, and physical activity (global categorical test, p < 0.001). Lower knowledge alignment among shorter-duration women reflected greater uncertainty rather than greater myth endorsement, which remained rare across duration groups. Compared with men, women were less likely to report athletic performance as a goal (adjusted 37.5% vs. 50.2%) and more likely to report healthy aging, while six of seven information sources differed by gender. Women also had lower knowledge-alignment scores overall, yet the largest gender difference emerged in confidence: at equivalent observed knowledge alignment, women reported progressively lower self-rated confidence than men as scores increased (interaction p = 0.012), with an adjusted difference of -0.38 points at the highest observed knowledge score.

Among current and recent SuppCo users who responded to this survey, women showed a pattern of creatine use that differed from the historically performance-focused populations underlying much of the evidence base. Women were disproportionately represented in shorter reported duration-of-use categories, more often endorsed healthy aging and less often athletic performance, and reported different information sources than men. Lower knowledge alignment among shorter-duration women reflected greater uncertainty rather than greater endorsement of misconceptions, while women reported lower confidence than men at the highest observed knowledge levels. These findings suggest future research and education should go beyond efficacy trials in women to address who is using creatine, the outcomes they expect, where they obtain information, and how knowledge and confidence shape decision-making. Prospective studies are needed to determine what underlies the difference in women's representation across reported duration-of-use groups.