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It’s never easy for parents to talk to their teens about having sex. Many parents feel that talking about it is the same as condoning it, so they are hesitant to do so. But according to the most recent Youth Risk Behavior Survey (YRBS), a national survey of high school students, by the end of high school 30% have had sex.

It can be impossible to know for sure if your teen has had sex. Even if they haven’t, it’s likely that at some point they will — and they need to have information to help keep themselves safe and healthy.

What parents should know about sexually transmitted infections

Sexually transmitted infections, or STIs, are very common. They may be caused by bacteria, viruses, or other microorganisms, and spread through all kinds of sex. While most STIs are treatable, they can affect fertility in both women and men, can cause health problems for a baby during pregnancy, and can sometimes lead to lifelong infection or serious complications. That’s why teens need to know about them.

Below are the high-level facts about some of the most common infections: what causes them, what symptoms may occur, and how they are treated.

Chlamydia

Chlamydia is the most frequently reported bacterial STI in the United States — but just as many cases are asymptomatic, so the numbers may be higher than we realize.

Symptoms, if they are present, can include discharge from the vagina or penis, pain with urination, or pain and swelling of the testicles (this is rare). A test of the urine (or a swab from the affected area) can diagnose it, and it is curable with antibiotics. If left untreated it can lead to infertility, more commonly in women than men.

Gonorrhea

Gonorrhea is another STI caused by a bacteria, and it can also be asymptomatic. When symptoms occur, they are very similar to chlamydia. Gonorrhea also can cause infertility in both women and men. While it is treatable, some infections have been resistant to the usual antibiotics used, so additional testing and treatment is sometimes needed.

Trichomoniasis

Trichomoniasis is caused by a protozoa. It is another STI that can be asymptomatic. When there are symptoms, they are usually itch, irritation, and discharge. It is curable with medication.

Syphilis

Syphilis has been on the rise. In the first stage of infection there is usually a firm, round, painless sore where the infection entered the body. The sore is generally there for three to six weeks, but as it is painless it may go unnoticed.

In the second stage there is a more extensive rash, though it can be faint and go unnoticed, along with general feelings of illness such as fever, sore throat, fatigue, swollen lymph nodes, or weight loss.

If syphilis still goes unnoticed it can linger in the body for years, sometimes affecting organ systems, including the brain. It is curable with antibiotics, but if found late the damage it can do may be permanent. This infection can be very serious during pregnancy.

HSV

HSV (herpes simplex virus) causes blistering sores. There is both oral herpes (mouth sores) and genital herpes. Oral herpes, caused by HSV1, is not usually caused by sex — but it can lead to genital herpes through oral sex. Genital herpes is more commonly caused by HSV2.

The sores of herpes can recur throughout life. There is no cure for herpes, but there are medications that can shorten or prevent outbreaks. This infection can be particularly dangerous during pregnancy, although the risks can be managed with good prenatal care.

HPV

HPV (human papilloma virus) is the most common sexually transmitted infection. It can be transmitted even by close skin-to-skin touch, and infections are generally asymptomatic.

Most cases of HPV (90%) get better by themselves — but if they don’t, over time the virus can cause genital warts or certain cancers. Luckily, there is an effective vaccine to prevent HPV that can be given starting at age 9.

HIV

HIV (human immunodeficiency virus) is more common among people who have other STIs — mostly because having STIs is a sign of risky sexual behavior. It can be very hard to know if a person has it, because the early symptoms can feel like having the flu, and then people can move into a long period of time of having no symptoms at all.

While there is no cure for HIV, there are medications to control it, as well as medications that can prevent it.

Talking to teens about preventing STIs

All of this sounds scary. But there are actually some simple things teens can do to prevent infections or minimize complications, which is why parents need to talk with them.

Teens can:

• Use condoms every single time they have sex — and use them properly. According to the report mentioned above, about half of sexually active high schoolers don’t use condoms regularly.
• Limit their number of sexual partners — and have frank conversations with those partners before having sex. Asking about sexual history, and getting testing before starting a sexual relationship, can make a difference.
• Get tested regularly. Sexually active teens should be tested for gonorrhea and chlamydia every year, or more frequently based on their sexual history or symptoms. Testing for other infections may be a good idea too. In the YRBS, 95% of high schoolers had not been tested for STIs in the past year, which is frightening given that nearly a third report being sexually active.

Make sure your teen sees their doctor regularly. And encourage them to be honest with their doctor during their visits. As a parent, you can help by giving your teen confidential time alone with the doctor.

About the Author

Claire McCarthy, MD, Senior Faculty Editor, Harvard Health Publishing

Claire McCarthy, MD, is a primary care pediatrician at Boston Children’s Hospital, and an assistant professor of pediatrics at Harvard Medical School. In addition to being a senior faculty editor for Harvard Health Publishing, Dr. McCarthy … See Full Bio View all posts by Claire McCarthy, MD

Here’s a new fact about spring, summer, fall, and sometimes even winter: now that climate change has blurred seasonal boundaries, sizzling heat may be on the way, or currently blanketing your community.

High temperatures stress the body, leading to thousands of heat-related illnesses and deaths every year in the US. Creating a personal heat plan can help you stay safe when the heat index soars.

Caleb Dresser, MD, MPH, is the health care solutions lead for C-CHANGE, the Center for Climate Health and the Global Environment at the Harvard T.H. Chan School of Public Health, and an emergency medicine doctor at Harvard-affiliated Beth Israel Deaconess Medical Center. Below we interview him about who, how, and why heat harms. Then we’ll help you create your personal heat safety plan.

Interview edited for clarity

Who is especially vulnerable during hot weather?

High temperatures can affect anyone. But some people — children, outdoor workers, people who are pregnant or have health problems or disabilities, and older people — are more likely to experience harm when temperatures rise. For example:

• Young children, especially babies, have less physical capacity to deal with very high temperatures.
• People working outdoors may not have access to shade and could be performing physically intensive labor. They need adequate hydration, adequate breaks, and access to a cool space during break time, as OSHA guidelines spell out.
• People with chronic medical conditions, such as kidney disease or heart disease, may have difficulty adapting physiologically to hot weather, or may be more susceptible to its health impacts.
• And some people living with disabilities or certain neurological conditions may have difficulty with thermoregulation — that is, controlling the temperature of their bodies — or may not be able to take actions that keep them safe, such as taking off layers or moving to a cool area.

Which weather patterns create dangerous levels of heat?

Dangerous heat is the result of both high temperatures and high humidity, which interfere with our ability to cool off by sweating. In dry areas, extremely hot temperatures can be dangerous on their own.

Danger zones vary across the United States and around the world. But hospital use and deaths rise once we get above threshold temperatures. The threshold varies in different places depending on whether bodies, cultures, and architecture are adapted to heat.

For example, here in New England, where some people (particularly those of limited means) may not have access to air conditioning, we see increases in healthcare use and deaths at a lower temperature than in the American South, where people and organizations may be more used to dealing with hot weather.

When does hot weather become dangerous to our health?

Risk goes up the longer hot weather sticks around.

One hot day can put some people at risk. A stretch of several hot days in a row during a heat wave is particularly dangerous because it can overwhelm people’s ability to adapt. Eventually people run out of physiological reserves, leading to greater health harms and greater need for medical care.

Surprisingly, spring and early summer are particularly dangerous times because people and organizations aren’t as prepared for hot weather.

How to create your personal heat safety plan

Five key points to help you create a personal heat plan are below. Americares offers further information through heat tip sheets developed with the Harvard C-CHANGE team that are tailored to people in different health circumstances.

Planning is important because intense heat is occurring more often: a Climate Central analysis found 21 additional risky heat days, on average, for 232 out of 249 locations between 1970 and 2022.

• Stay ahead of hot weather. Check apps, websites, TV, or radio for updates on weather today and in coming days. If local weather alerts are available by phone or text, sign up.
• Have a cooling plan. When temperatures soar, you need to spend as much time as possible in cool spaces. Plan options if your home is likely to be too hot and unsafe to stay in. You may be able to stay with a neighbor or family member who has air conditioning until a heat wave passes. Many cities and towns have neighborhood splash pads for children, and open cooling centers or air-conditioned libraries, public buildings, or community centers to everyone — sometimes even overnight. Spending time in air-conditioned businesses or malls, or in a shady green space like a park, may help too.
• Sip plenty of fluids. Water is the best choice. Skip sugary drinks and avoid caffeine or alcohol.
• Use fans correctly. Fans help if surrounding air is relatively cool. If air temperatures are very high, it’s important to dampen your clothes or skin to help keep your body from overheating, and move to a cooler location, if possible.
• Know your personal risks and the signs of heat-related illness. If you have health problems or disabilities, or take certain medicines such as diuretics, talk to your doctor about the best ways for you to cope with heat. It’s also essential to know the signs of heat-related illnesses, which range from heat rash and sunburn to heat cramps, heat exhaustion, and heat stroke. This chart from the Centers for Disease Control and Prevention describes the signs to look for and what you can do, particularly when heat becomes an emergency.

About the Author

Francesca Coltrera, Editor, Harvard Health Blog

Francesca Coltrera is editor of the Harvard Health Blog, and a senior content writer and editor for Harvard Health Publishing. She is an award-winning medical writer and co-author of Living Through Breast Cancer and The Breast … See Full Bio View all posts by Francesca Coltrera

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD

An F may mean failure in school, but the letter earns high marks in your diet. The two biggest dietary Fs — fiber and fermented foods — are top priorities to help maintain healthy digestion, and they potentially offer much more. How can you fit these nutrients into meals? Can this help your overall health as well as gut health?

Fiber, fermented foods, and the gut microbiome

The gut microbiome is a composed of bacteria, viruses, fungi, and other microorganisms living in the colon (large intestine). What you eat, the air you breathe, where you live, and many other factors affect the makeup of the gut microbiome. Some experts think of it as a hidden organ because it has a role in many important functions of the body — for example, helping the immune system function optimally, reducing chronic inflammation, keeping intestinal cells healthy, and providing some essential micronutrients that may not be included in a regular diet.

Your gut communicates with your brain through pathways in the gut-brain axis. Changes in the gut microbiome have been linked with mood and mental health disorders, such as depression and anxiety. However, it’s not yet clear that these changes directly cause these types of problems.

We do know that a healthy diet low in processed foods is key to a healthy gut microbiome. And increasing evidence suggests that fiber and fermented foods can play important parts here.

Fiber 101

Fiber’s main job is to make digestion smoother by softening and adding bulk to stool, making it pass quickly through the intestines.

But fiber has other benefits for your microbiome and overall health. A high-fiber diet helps keep body weight under control and lowers LDL (bad) cholesterol levels. Research has found that eating enough fiber reduces the risk of heart disease, type 2 diabetes, and some cancers.

What to know about fiber

There are two types of fiber: insoluble (which helps you feel full and encourages regular bowel movements) and soluble (which helps lower cholesterol and blood sugar). However, recent research suggests people should focus on the total amount of fiber in their diet, rather than type of fiber.

If you’re trying to add more foods with fiber to your diet, make sure you ease into new fiber-rich habits and drink plenty of water. Your digestive system must adapt slowly to avoid gas, bloating, diarrhea, and stomach cramps caused by eating too much too soon. Your body will gradually adjust to increasing fiber after a week or so.

How much fiber do you need?

The fiber formula is 14 grams for every 1,000 calories consumed. Your specific calorie intake can vary depending on your activity levels.

“But instead of tracking daily fiber, focus on adding more servings of fiber-rich foods to your diet,” says Eric Rimm, professor of epidemiology and nutrition at Harvard’s T.H. Chan School of Public Health.

Which foods are high in fiber?

Fruits, vegetables, legumes, nuts, seeds, and whole grains are all high in fiber. The Dietary Guidelines for Americans has a comprehensive list of fiber-rich foods and their calorie counts.

What about over-the-counter fiber supplements that come in capsules, powders that you mix with water, and chewable tablets? “If you have trouble eating enough fiber-rich foods, then these occasionally can be used, and there is no evidence they are harmful,” says Rimm. “But they should not serve as your primary source of dietary fiber.”

Fermented foods 101

Fermented foods contain both prebiotics — ingredients that create healthy changes in the microbiome — and beneficial live bacteria called probiotics. Both prebiotics and probiotics help maintain a healthy gut microbiome.

What to know about fermented foods

Besides helping with digestion and absorbing vital nutrients from food, a healthy gut supports your immune system to help fight infections and protect against inflammation. Some research suggests that certain probiotics help relieve symptoms of gut-related conditions like inflammatory bowel disease and irritable bowel syndrome, though not all experts agree with this.

Many foods that are fermented undergo lacto-fermentation, in which natural bacteria feed on the sugar and starch in the food, creating lactic acid. Not only does this process remove simple sugars, it creates various species of good bacteria, such as Lactobacillus or Bifidobacterium. (Keep in mind that some foods undergo steps that remove probiotics and other healthful microbes, as with beer or wine, or make them inactive, like baking and canning.)

The exact amounts and specific strains of bacteria in fermented foods vary depending on how they are made. In addition to probiotics, fermented foods may contain other valuable nutrients like enzymes, B vitamins, and omega-3 fatty acids.

How often should you eat fermented foods?

There is no recommended daily allowance for prebiotics or probiotics, so it is impossible to know precisely which fermented foods or quantities are best. The general guideline is to add more to your daily diet.

Which fermented foods should you choose?

Fermented foods have a range of tastes and textures because of the particular bacteria they produce during fermentation or that are added to foods. Yogurt is one of the most popular fermented foods (look for the words “live and active cultures” on the label). Still, many options are available if you are not a yogurt fan or want to expand your fermented choices. Kimchi, sauerkraut, kombucha, and pickles are a few examples.

As with fiber, probiotics are also marketed as over-the-counter supplements. However, like all dietary supplements, they do not require FDA approval, so there is no guarantee that the types of bacteria listed on a label can provide the promised benefits — or are even in the bottle. “Therefore, it is best to get your probiotics from fermented foods,” says Rimm.

To learn more about the value of fiber, fermented foods, and a healthy gut microbiome, listen to this episode of the Food, We Need to Talk podcast, “Understanding the Microbiome.”

About the Author

Matthew Solan, Executive Editor, Harvard Men's Health Watch

Matthew Solan is the executive editor of Harvard Men’s Health Watch. He previously served as executive editor for UCLA Health’s Healthy Years and as a contributor to Duke Medicine’s Health News and Weill Cornell Medical College’s … See Full Bio View all posts by Matthew Solan

About the Reviewer

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio View all posts by Howard E. LeWine, MD