You're Training Hard and Taking Your Supplements. So Why Aren't You Seeing the Results You Expected?
Let me guess. You're consistent with your training, you hit your protein, you've invested in the supplements everyone seems to be recommending — and yet something still feels like it's not quite clicking. Before you add another product to your routine, I want to walk you through a brand new piece of research that I think every woman who takes her health seriously needs to read.
A systematic review and meta-analysis published in 2026 pulled together 14 randomized controlled trials following 763 women across every reproductive stage — premenopausal, perimenopausal, and postmenopausal — all of whom were combining nutritional supplements with structured exercise. The supplements ranged from whey and soy protein to BCAAs, leucine, collagen peptides, creatine, and L-citrulline. The question the researchers were asking was simple: does adding a supplement on top of exercise actually do more than exercise alone?
The answer is more nuanced than the supplement industry would like you to believe.
The Muscle Mass Results Are Going to Sting a Little
Here's the part that surprised me, and honestly, the part that should make all of us pause before we next add something to our cart.
Across three separate measures of muscle mass — skeletal muscle mass, appendicular lean mass, and fat-free mass — adding nutritional supplements to an exercise program made virtually no statistically significant difference compared to exercise alone. We're not talking about a small difference. We're talking about effect sizes so close to zero they barely registered.
That includes protein powders. It includes amino acids. Across the board, when it came to actually building and maintaining muscle mass, the supplements weren't moving the needle.
Now, before you throw your protein shaker out the window, let's talk about what this actually means — because context matters here.
Strength Is a Different Conversation
Not everything came back flat. Upper-body strength — specifically bench press performance and handgrip strength — did show statistically significant improvements in women who were supplementing alongside their training. That's worth paying attention to.
But here's the detail that really matters: when you look closely at which studies drove those upper-body strength gains, three out of four of them were using creatine, not conventional protein supplements.
Creatine works differently to protein. It doesn't directly build muscle the way amino acids do — it fuels your ability to work hard during high-intensity effort by replenishing energy faster during training. That's likely why you see strength improvements without a corresponding change in muscle mass. You're performing better in the gym, which over time supports adaptation, but the supplement itself isn't directly stacking muscle onto your frame.
Lower-body strength — leg press, leg extension — showed no significant improvements with any supplement. And I want you to sit with that for a second, because lower-body strength is the thing that keeps you mobile, keeps you independent, and dramatically reduces your risk of falls as you age. That's not a small thing.
The Problem That Was There the Whole Time
Here's what I think is the most important finding in this entire paper, and it barely gets mentioned in the headline results.
Most women in these studies were coming in already under-eating protein. Average baseline intake across studies was somewhere between 55 and 83 grams per day. The research suggests that women looking to maintain and build muscle — especially those navigating the hormonal shifts of perimenopause and menopause — need closer to 1.2 to 1.6 grams of protein per kilogram of bodyweight daily. For a 70kg woman, that's 84 to 112 grams. Many of these women, even with their supplement, weren't reliably hitting that.
You can't out-supplement an under-fuelled diet. And this is where I see so many women going wrong — not because they're lazy or uninformed, but because they've been sold the idea that the supplement is the solution rather than a small addition on top of an already solid foundation.
There's another layer to this that doesn't get enough airtime. When you're in perimenopause or beyond, your body becomes less efficient at using the protein you consume. The biological process of converting dietary protein into muscle tissue gets blunted by declining oestrogen. That means your protein requirements likely increase at the exact same time that life gets busier, stress goes up, and sleep often gets worse. A 25 gram shake isn't going to bridge that gap on its own.
What About Bone Health?
The research on bone health is inconclusive — but not for the reasons you might think.
The studies in this review were too short and measuring the wrong things to draw any meaningful conclusions. Most ran for around 16 weeks. Meaningful changes in bone density typically take at least 12 months to show up on a scan. Beyond that, researchers were measuring whole-body bone density rather than the specific sites — the lumbar spine, the hip, the femoral neck — that are actually most relevant to fracture risk in women.
This isn't evidence that supplements don't support bone health. It's evidence that we haven't yet done the research properly enough to know. Those are very different statements, and collapsing them into "supplements don't help bones" would be misleading. What I can tell you is that progressive resistance training — particularly high-intensity resistance training combined with impact work — has a stronger evidence base for bone health in women than any supplement currently does.
So What Do You Actually Do With All of This?
First, your training comes before everything else. Consistently and progressively challenging your body through resistance training is the single most evidence-backed thing you can do for your musculoskeletal health across every stage of your reproductive life. No supplement replaces that, and this research confirms it clearly.
Second, audit your total protein intake before you add anything else. Not just whether you're having a shake, but whether your overall daily intake is actually meeting your needs. Use your bodyweight as a guide, work toward that 1.2 to 1.6 grams per kilogram target, and build it from whole foods first. The supplement should genuinely be supplementing something solid, not compensating for something absent.
Third, if you are going to add a supplement, creatine currently has the most meaningful evidence base for women — particularly for strength performance. It's one of the most researched supplements in existence, it's safe, it's inexpensive, and it appears to offer real benefits for upper-body strength when combined with resistance training. If you're perimenopausal or postmenopausal and you're not already considering it, it's worth a conversation with your practitioner.
Finally — and I say this gently — be a little more sceptical of what gets marketed to you. The supplement industry is extraordinarily good at making you feel like you're one product away from the results you want. Most of the time, you're not missing a supplement. You're missing consistency, sufficient protein, and enough sleep. None of those things come in a tub.
The research is still evolving. We need longer studies, better bone health measurements, and more focus on women at different hormonal stages specifically. But what we know right now is enough to make smarter decisions — and that's always where we start.
Chen, K-H., et al. (2026). Nutritional Supplementation Combined with Exercise for Musculoskeletal Health in Women: A Systematic Review and Meta-Analysis. International Journal of Medical Sciences, 23(6), 1933–1951. doi: 10.7150/ijms.130435
