Lucy’s double chocolate chip seed cycling PMS Cookies

My gosh, these cookies took me about 10 recipe tests to get right, but I did it! And I’m so glad I did, because they’re the best damn cookies I’ve ever made, and they include ingredients that can actually help you manage PMS and reduce your endo symptoms!

So, why have I gone to such an extent to get these cookies right?

Because what we eat can genuinely help us manage endo and balance our hormones - and the science is backing us up. And because my client Lucy, needed some cookies, stat!

Recently, two major studies have shown the power of dietary changes for endometriosis and hormones.

The first, you may have heard about, was a large scale study that showed improvements in endo pain with the removal or limits of certain foods like gluten, alcohol, caffeine, dairy and sugar. Now, whilst not everyone saw improvements, roughly about 40-50% of participants did (you can check out the specific date here).

Does this mean you can never eat gluten or have a glass of wine again? No - for many, it may very well be about finding a tolerance level that suits them, or keeping intake to smaller amounts or less frequent. I see this very often with my clients (and have experienced it for myself) - daily intakes or frequent intakes of certain foods are associated with more severe symptoms, but these same clients can often find a reduced intake may be just as beneficial as removing those foods entirely, without such severe restriction. Also, some of us may be fine on dairy, but not so much gluten, or vice versa, rather than it being about all of these foods - remember, it’s about your body and how you personally respond.

For today’s recipe, I want to highlight a few findings from this study:

• 45.4% of participants who removed gluten experienced reduced pain

• 45.2% of participants who removed dairy experienced reduced pain

• Over 40% of participants who reduced processed sugar experienced reduced pain, whilst just under 40% who reduced processed foods experienced a reduction in pain.

To further support these findings, we also have data from other research showing an association with processed foods/junk food (a.k.a foods high in sugar, unhealthy fats, low in nutrients, etc) and the prevalence of PMS.

Now, I want to highlight another study, this time, a study not done on endo, but on PMS and cycle health. The founders behind BeeYa Wellness conducted a three month clinical trial into the effects of seed cycling. A strategy which uses 1 tbsp ground flax and 1 tbsp ground pumpkin seeds per day in the menstrual and follicular phases, and then 1 tbsp ground sunflower and 1 tbsp ground sesame seeds to support hormonal and cycle health. The strategy is based on the nutritional benefits of these seeds, which contain hormone supportive nutrients such as zinc and magnesium, and also feature specific beneficial phytoestrogens which can support healthier oestrogen levels and oestrogen metabolism (more on that in a moment). We have individual studies on some of these seeds and their benefits for hormonal health, especially flax, and one study into the benefits of seed cycling on PCOS, but we didn’t have a study showing the positive effects we see with seed cycling in general, though clinically, myself and many practitioners do see some incredible results!

So, here are some of the major findings:

• 80% reported less breast tenderness

• 75% reported PMS was less severe

• 77% reported less severe cramps

• 80% reported menstrual pain was less severe

• 72% reported improved digestion

Digestion problems, pre-period cramps, PMS, breast tenderness and for course, painful periods, are all symptoms nearly every single endo client comes to me with - and if you’re the same, or you share similar symptoms, you can see why seed cycling may be appealing!

Which brings me to this week’s recipe.

It’s natural that we crave sugary, starchy and salty foods in our luteal phase. This is a time when our blood sugar is more unstable and our energy requirements are higher. We’re also lacking in the mood boosting benefits of oestrogen (which supports serotonin production) so we crave foods that will provide us with a soothing and feel good hit of dopamine!

I wanted to provide us with that dopamine hit, without the negative affects that can come with some of the typical ingredients in feel good snacks like cookies, plus I wanted to feature star ingredients and nutrients that actually could help with our symptoms - such as flax, sesame seeds and sunflower seeds (don’t worry if you don’t like tahini, there are swaps below).

I also really, really wanted to mimic some cookies my client Lucy absolutely loves, but are high sugar. So, to provide her with a hormone loving alternative that match the original as close as possible, these cookies are designed to have that beautiful crinkle/cracked effect on the surface, and are slightly crisp on the outside, but chewy and soft on the inside.

Now, don’t worry if you don’t like the flavour of tahini, in the notes below, I provide you with swaps - but essentially, almond butter will give you almost just as much nutrition, and will make these cookies more like regular chocolate flavour vs. tahini chocolate flavour.

So, this recipe…

Is rich in calcium, which can play a significant role in reducing PMS mood related symptoms and period pain.

Given that some people with endometriosis feel worse from dairy, unless we’re intentional, calcium intake may be significantly reduced (in fact, a number of my clients are deficient in this mineral). Low levels of calcium have been repeatedly associated with increased PMS symptoms and research has shown that treatment with calcium supplements can reduce the syndrome and even period pain because low levels of calcium can cause more contractions.

Sesame seeds and tahini (which is a better way to absorb the nutrients in sesame seeds, otherwise we just poop them out) provide a significant amount of calcium, and the sunflower seed butter and flax also offer a decent amount too, with most of the other ingredients providing a nice little boost as well. As a result, a serving (two cookies) provides 162 mg of calcium, which is almost 25% of our RDA of 700mg. Now, you can even up that significantly if you used unhulled tahini - with unhulled tahini, you can get almost 300mg per serving, meeting 40% of your RDA! Just keep in mind that unhulled tahini tends to taste a bit more bitter and earthier, it can also be slightly less smooth than hulled, but you’ll be blending the mixture, so consistency isn’t really a problem here.

Provides a therapeutic amount of flax seed to support healthy oestrogen metabolism.

Flax seeds are rich in a type of fibre called viscous fibre, which creates a gel-like substance in the gut, and bulks out bowel movements, improving regularity and treating constipation. This is absolutely essential for the last step in clearing out oestrogen - we want to be having at least one bowel movement a day to keep oestrogen at a healthy level. When oestrogen is hanging out in the gut, not going anywhere, it can be reabsorbed, creating higher levels of oestrogen once again.

This is especially true if we have elevated levels of an enzyme called beta glucuronidase, that can be high in people with endo, and recirculates waste oestrogen. The good news? Eating a diet rich in fibre (which flax seed offers in great amounts) helps to lower levels.

Flax seeds have also been shown to improve the metabolism of oestrogen through the liver, by increasing the amount of healthy oestrogen waste products (known as metabolites) and reducing the amount of the more potent, harmful ones, which can cause more oestrogenic activity.

Finally, flax contains lignans, plant compounds that have mild oestrogen-like effects, but are no where near as potent as oestrogen. Structurally, they mimic oestrogen and so can bind to oestrogen receptors. Think of a receptor as the lock, and oestrogen as they key, when we turn the lock, it triggers an oestrogen activity like thickening of the uterine lining. This can actually reduce the impact of high oestrogen levels, but also supports low levels, in menopause, for example.

In fact, one study showed that the participants who consumed 10g fresh, ground flax seeds (uncooked), daily for three cycles had longer luteal phases and a higher progesterone to oestrogen ratio in the luteal phase as well. You’ll be pleased to know that these cookies provide 10g of flax per serving (2 cookies).

Now, despite what the research shows, everyone is individual, so if you find flax seeds make you feel more oestrogen dominant, please listen to your body, and I advise you listen/or read this and this, for more info on how to use flax for your body and endo.

Is high in vitamin E which can help reduce inflammation and period pain, and support healthy progesterone levels.

Just 30g of sunflower seeds can provide nearly 50% of your RDA, and these cookies should give you somewhere in the region of 25-30% of your daily requirements. The tahini helps top up levels too!

Vitamin E can help us manage endo and the associated pain that comes with it. A recent meta-analysis of over 589 participants, concluded that vit E supplementation can reduce period pain, pain with sex, daily pelvic pain and even improve quality of life with endometriosis patients. And a systematic review and meta-analysis of eight studies and over 1000 people concluded that vitamin E significantly reduced period pain and could be used as a treatment for dysmennorhea.

But it’s not just supplements that help - food helps too!

One study found people with endo had a 40% reduced intake of vitamin E, but levels increased after following a high antioxidant diet, and oxidation levels reduced by 20% - this study actually used sunflower seeds as their main vitamin E provider.

Vitamin E can also help raise progesterone levels, and whilst we’re not using as high a dose as used in the studies, ensuring you’re getting enough vit E can support a healthy corpus luteum and progesterone production.

Is a great source of key B vitamins for hormone health, reducing menstrual pain and supporting energy and mental health.

These cookies provide folate (B9), and vits B6 and B1 in significant amounts - just two cookies provide almost 30% of your B1 RDA, 15% of your folate needs and up to 20% of your B6 daily requirements!

B6 is one of the most important B vitamins for balanced hormones as it supports progesterone production and oestrogen metabolism. Many people with endo suffer with depression and anxiety, but also, if you suffer with hormonal imbalances like low progesterone, this can also cause significant mood shifts because our sex hormones support neurotransmitter production and regulation.

B6 plays a pivotal role in the production of feel good neurotransmitters serotonin and dopamine, whilst also supporting GABA production, our calming neurotransmitter.

Oestrogen regulates both serotonin and dopamine, and so when oestrogen dips in our luteal phase, some of us can feel the effects of this, especially if we’re low in progesterone. Progesterone upregulates GABA receptors (basically, makes us more sensitive to GABA so it’s more effective) and so when progesterone is low, we can really feel the lack of GABA support - in fact, low levels of GABA have been linked to PMDD.

Finally, research has shown that B6 treatment can help reduce PMS, especially the mood challenges that can come with the syndrome.

Low folate levels can cause irritability, mood swings and fatigue, whilst low B1 levels have been associated with more severe menstrual cramps, and treatment with B1 has been shown to significantly reduce period pain.

Is high in minerals magnesium and iron to support energy, PMS and menstrual health.

Research has shown magnesium to be an effective treatment in preventing dysmenorrhea (period pain) because it reduces inflammatory prostaglandins that are the drivers of both endo and period pain. One study showed that six months of magnesium treatment reduced prostaglandin F2a by over half!  In fact, in recent research, magnesium is being explored as a dietary treatment for endo and a higher intake of magnesium rich foods was associated with a lower risk of endo. Additionally, magnesium helps to regulate our sex hormones, and as result, is a recognised treatment for preventing PMS. A serving of these bad boys provides about 30% of your RDA from the tahini, cacao and flax.

But we also have iron, at about 20-30% of your RDA per serving. Iron deficiency is extremely common in general, but even more so in people with heavy menstrual bleeding. Iron plays a major role in preventing fatigue, and yet many of the clients who I work with, come to me with significantly low levels due to having SIBO, avoiding red meat, heavy periods or other reasons. Supporting healthy iron absorption and intake is a key part of beating endo fatigue and recovering from heavy blood loss and low levels can cause brain fog, extreme tiredness, heart palpitations, dizziness, muscle weakness and depression to name a few.

Now, it’s worth noting that iron from plant foods is a type of iron called non-heme iron, and it’s typically harder to absorb. Pairing these cookies with a source of vitamin C, like strawberries, can actually aid absorption.

Is a great source of prebiotic and soluble fibre for microbiome health and bowel regularity.

People with endo have already been shown to have microbiome dysbiosis, with lower levels of some beneficial bacteria and higher levels of pathogenic (bad) bacteria, which can not only fuel IBS symptoms like bloating, but also inflammation.

These cookies are a great source of polyphenols from the cacao and flax. Polyphenols are types of antioxidants found in certain plant foods that not only reduce inflammation levels and improve overall health, but they are also a favourite food for our gut microbiome, which means that can support our good gut bugs to thrive.

Additionally, flax seeds contain prebiotic fibre, which is fibre that resists digestion and ends up in the large intestine, where it feeds gut bugs. This in turn increases levels of short chain fatty acids (SCFA), beneficial gut compounds which are produced when good bacteria eat fibre. These guys help to keep inflammation down in the gut and the body, help to keep blood sugar levels healthy, inhibit bad bacteria and foster good bacteria growth.

Because research suggests that people with endo may have gut inflammation, high levels of unhealthy gut bacteria and low levels of beneficial bacteria, as well as blood sugar issues, and often low levels of short chain fatty acids, replenishing SCFA levels and restoring the microbiome management is essential to endo belly and endo management overall.

Finally, as we explored earlier - flax helps keep you regular. In fact, it’s an evidenced based treatment for constipation, which I know many endo peeps struggle with, especially in the luteal phase when progesterone can slow down motility.

Is blood sugar balancing and sweetened only with moderate amounts of fruit to prevent glucose spikes and inflammation.

Most cookies are laden with simple starches and sugars, and tend to cause elevated blood sugar levels. They’re also classified, when store bought, as ultra processed, which as we explored earlier, can potentially contribute to more PMS and endo pain.

I wanted to create a healthy, functional food cookie that was lower in sugar, used wholefoods to sweeten and didn’t spike blood sugar, but also tasted good. I’ve sweetened only with dates, and have kept the amount of dates to a moderate portion, so that each serving is only 7-9g of naturally occurring sugar (and a little from the dark chocolate).

I also added our sidekicks fat, fibre and protein in the form of nut butter and flax. These can help slow down the release of glucose to the blood stream, creating a steadier stream of glucose vs. a big spike. And flax seeds also provide viscous fibre, a type of soluble fibre that forms a gel in the gut, and is particularly beneficial for blood sugar because it significantly slows down the digestion of glucose.

So why does this matter?

Keeping blood sugar levels stable helps to prevent oxidative stress, which leads to more inflammation in the body and that may trigger further pain and symptoms. In fact, oxidative stress is higher in people with endo, and it’s a key driver of endo growth.

When we’re in our luteal phase, we often experience more blood sugar swings because oestrogen, which dominates in our follicular phase, helps us regulate our blood sugar response, but is lower in the luteal phase. As a result, we tend to get cravings for sweet foods or foods high in starch. The problem is, these foods keep us on a blood sugar rollercoaster, and raise inflammation levels, resulting in more of those inflammatory symptoms and pain that we’re trying to avoid. These cookies, being low in sugar and rich in fibre, can help us get our fix without the pain triggering spikes.

Additionally, constant blood sugar swings can take their toll on hormones, leading to issues like elevated androgens (think testosterone), which can affect ovulation and cycle length. Blood sugar swings may also cause oestrogen excess or dominance and low progesterone if ovulation is interrupted or stopped entirely.

Finally, blood sugar swings are linked heavily with mood disorders such as depression and anxiety, so if you struggle with low moods in your luteal phase, supporting blood sugar can actually support your mental health!

Important notes to help you tailor this recipe to your own body and needs (and tastebuds!)

Sweetness and blood sugar

These won’t taste like your store bought cookies because they don’t have anywhere near the amount of sugar in them, but as you begin to reduce your sugar intake, your tastebuds should adjust! They’ll also adjust after a few bites too.

If you want to boost the sweetness, use medjool dates as they’re higher in sugar than most dates, and go for an 85% rather than a 90% chocolate, because again, it’ll have slightly more sugar. Don’t worry, the sugar content of these won’t be too different (though do check the labels of the chocolate, some brands do whack up the sugar content), and as I said, I’ve added flax, nut butter, etc. to support blood sugar, and I’ve kept the amount of dates moderate as well.

As with all sweet snacks, they are best consumed after meals because the fibre, fat and protein from your meal helps slow down the release of glucose, or you can consume before an activity, like a walk, etc. which helps use the glucose in the cookies for fuel. This is just the ideal scenario for blood sugar - but as I’ve said, I’ve made these cookies as blood sugar supportive as possible (without making them with a sugar free alternative or keto), so in theory, you should be able to enjoy as a snack watching a movie, without having to worry!

Everyone’s blood sugar is different, so judge how you feel after the cookies or measure your glucose levels if you’re really curious, to see how you respond. If you feel (or see on a glucose monitor) that these spike you, try eating the two cookies one by one, at separate times, so you still get the therapeutic amount of flax across the day, but you’re not having as much sugar in one go (even though it’s not a lot!).

Nut butter swaps

If tahini isn’t your thing, I get it. I’ve used tahini specifically in this recipe due to its high calcium content, and because sesame seeds feature in the luteal phase of seed cycling due to their progesterone supporting nutrients. However, if you’d like to swap, you could go to for pure almond butter, which would give you almost as much calcium and would significantly increase the vitamin E content. If you’re allergic to nuts, you could go purely for sunflower seeds - the calcium content would be lower, but the vit E levels would be very high.

Endo belly and FOMDAPS

All the ingredients in this recipe come in as low FODMAPS per two cookies, so this means they are less likely to trigger bloating and endo belly because they are low in fermentable carbohydrates. But remember, everyone is different, and tolerance to foods and fibres can vary dramatically, especially if you have SIBO, so if you find two cookies at one sitting triggers bloating or any gut discomfort, try eating one at a time at separate sittings, and you may find you tolerate them better.

Oil separation

Creating an egg free, dairy free and gluten free cookie, without regular sugar, and making it chewy, is no easy task! One of the biggest problems I’ve had is oil separation from the nut butter due to the lack of flour. This final version is oily, but the oil isn’t spilling out whilst baking, which was happening with previous batches. I’ve added very specific instructions to the method to prevent the oil separation from happening too much - not soaking the dates, not adding liquid, folding the flax gel into the dry ingredients first before adding the but butter, and not over folding/mixing. Follow the method to the letter, and your dough will be fine - it’ll still be oily to handle (hence why I say shape with wet hands), but you shouldn’t have oil leaking out of the cookies during the baking time, which creates a dry cookie and affects the texture! These are oily, but they hold their oil, if that makes any sense?!

Further resources

If you’re struggling with your endo nutrition or gut health, you might find my courses and one to one coaching helpful. You can find out more here. I’ve also got endless podcast episodes on gut health and blood sugar.  

To understand more about the low FODMAP diet, start here.

Lucy’s double chocolate chip seed cycling PMS Cookies

Method:

• Preheat the oven to 160°C (fan) / 180°C (conventional). If you find after making these you want them chewier and crisper, go for 170/190°C next time, but you may need to remove a minute or two early as they may start to catch.*

• In a small bowl, combine the water and flax and stir well. Leave to gel whilst you work on the following steps.

• Pulse and then blend the dates, vanilla and nut/seed butters in a food processor until you get a smooth paste or dough like texture (depending on the thickness of your nut/seed butter and the type of dates you have, you could get one of the other, both are fine!). You might not be able to get it perfectly smooth because we’re not using a liquid, don’t stress about that - just get it as smooth as you can. Don’t soak dates first or be tempted to add liquid, as the oil from the nuts and the water will separate.

• In a separate bowl, add the oats, cacao powder, baking soda and salt and stir to combine.

• Chop your dark chocolate into fairly big chunks and set aside.

• Add the flax egg to the dry ingredients, and stir and fold well until a dough forms.

• Add the nut butter blend and then fold in again until a dough forms. Work fairly quickly here.

• Fold in the chocolate chips.

• With wet hands (this helps you handle the dough), divide into 6 equal balls and place on the baking tray, evenly spaced.

• Press down with the back of a wooden spoon or with your hands.

• Bake for 12-13 minutes until the edges are crispy, but not burnt. The longer you leave them in, the chewier they’ll be. If you want a softer cookie, go for closer to 11-12 minutes.

• Leave on the tray for 5-10 minutes to cool before transferring to a wire cooling wrack, then leave to cool for another 20-25 (so they’ve had a total of 30 mins cooling). At this point, they’ll be chewy on the outside, but still warm and soft on the inside and can be eaten now. If you’d prefer them to be chewier, leave them to cool completely.

• Sprinkle with sea salt flakes before consuming, if desired.

• I store these in an airtight container in the fridge for up to three days.

* I have baked these at both temperatures and they both work well, it’s just that I found the higher temp caught the cookies a little, but the oven I am using runs a little hot.