Tense shoulders, clenched jaws, poor sleep, headaches and even nausea, are some of the common manifestations of stress. But stress can also contribute to hair loss, even disrupt menstrual cycles, each a possible byproduct of prolonged stress. And, prolonged stress, along with the health ramifications of Covid-19, has permeated the everyday reality of many since the pandemic began.

Getting Covid-19 itself can also cause hair loss. “It's something that is not uncommon,” explained Norman Rowe, MD. “ It's something actually to be expected after … someone had COVID.” Dr. Rowe, a plastic surgeon practices in New York City.

But why would Covid-19 change hair growth? Being sick is physically stressful. Viruses and bacteria are the invaders and the immune system wages war on them. This takes resources, in the form of energy. And that energy needs to come from somewhere, and sometimes it gets redirected away from hair growth. “Any type of illness can put the body in a hyper metabolic rate and in a stress mode,” said Dr. Rowe. Even the flu can cause hair loss. During the 1918 flu pandemic, alopecia was a common occurrence.

There’s even a technical term for this, it’s called Telogen Effluvium . “Telogen” refers to one of the phases of hair growth. Just like a growing plant that sprouts, blooms and then dies, hair has its own growth cycle. For people with telogen effluvium, growing hair abruptly stops growing and lapses into this resting phase of hair growth. When new hairs start growing, all the hairs that were at rest abruptly fall out, resembling hair loss.

Telogen effluvium can be caused by infections, surgery, crash diets or hormonal changes.

Even for people who haven’t been infected with the coronavirus, Dr. Rowe said the collective stress most people are living with could cause alopecia (hair loss) all on its own.

Good news, the hair will come back. According to Dr. Rowe, stress-induced hair loss is “generally reversible” although things won’t go back to normal overnight. “Usually...two, three four months after the event, the hair will stop being lost, and generally about six, eight months later you'll be back to where you were,” he explained.

For stress-related hair loss the passage of time might be the best treatment. For some people with dietary deficiencies, nutrition plays a role, but Dr. Rowe explained that apart from managing stress, there isn’t much a doctor could do for a patient with stress-induced hair loss. “You really don't need to do any type of treatment for it … other than dealing with the stress that caused it,” said Dr. Rowe.

In fact, doing too much might be more of a worry. Dr. Rowe warned against using too many hair care products, which can clog the pores in the scalp.

Hair loss of this type is more common in women, according to Dr. Rowe. With stress alopecia, “... it's usually a little bit more common in females, but it can affect men too.”

The impact stress has on hormones can be especially noticeable in women, causing changes in the menstrual cycle as well. Changing levels of stress, weight changes, even changes in daylight hours can affect the menstrual cycle.

Some changes to a menstrual cycle are okay, normal even. “Everyone is unique and special in their own way,” explained Gil Weiss, MD, “bodies work in slightly different ways.” Dr. Weiss is an OB GYN who works through Northwestern Medicine, in Chicago. Dr . Weiss said the average period comes every 28 days, but normal can be anything from 21 to 35 days. The active bleeding portion of a period typically lasts four to seven days.

And, for people who menstruate, the use of hormonal birth control can play a big role. People on hormonal birth control are likely to have a more regular period.

Of course, not all changes are normal, and so keeping track can help women notice big changes -- and then see a doctor about them.

On hormonal birth control, along with more regular cycles, the occasional skipped cycle is probably okay. “It's not that unusual,” said Dr. Weiss, emphasizing that it is only okay for people who have been regularly taking their birth control pill. Taking the pill incorrectly could lead to pregnancy. If you’ve skipped a period it’s probably a good idea to follow up with your doctor, but it isn’t necessarily a cause for concern,

For women not on hormonal birth control, Dr. Weiss thinks that after a skipped period it is reasonable to wait up to a week. Of course, all of this changes depending on the symptoms. “There’s kind of two major symptoms that are very common in pregnancy that are slightly uncommon as a cycle related thing,” said Dr. Weiss. Spotting is more common in early pregnancy, as is nausea, and vomiting.

Much of knowing when something is wrong involves knowing when something is right. “I think it's really important in general to pay attention to our bodies,” said Dr. Weiss who recommended an app or even a diary to record information.“I think it's helpful because it just provides us more information, and we can arrive at a better conclusion with more information,” he said.

Even in non-pandemic times, lifestyle factors and stress could lead to disruptions in menstrual cycle or hair growth. But, during Covid-19, there are more factors at play. Covid-19 as an illness could cause temporary hair loss and the stress many people have felt could do the same thing, even with getting sick. That, combined with the many lifestyle changes people have faced during Covid-19, from less time outside, to changes in diet and exercise, can all affect processes like menstruation and hair growth.

Even though there are reasonable explanations for physiological changes during Covid-19 Dr. Weiss stressed that people should reach out to their doctors with worries. After all, little changes can be just that, or they can be signs of something bigger.

Sabrina Emms is a science journalist. She got her start as an intern at a health and science podcast out of Philadelphia public radio. Before that she worked as a researcher, looking at the way bones are formed.
Medically reviewed by Yvonne Stolworthy, MSN, RN.