Polyendocrine metabolic ovarian syndrome-related risk symptoms and awareness among rural Chinese adolescent girls

Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), is the most common endocrine disorder among women of reproductive age and often manifests during adolescence. Awareness of PMOS remains limited, particularly in rural populations. This study aimed to assess self-reported PMOS-related symptoms, awareness, and associated factors among adolescent girls in rural China. A cross-sectional survey was conducted among 404 post-menarchal female students aged 12–16 years at a middle school in rural Shandong Province. A 26-item questionnaire assessed menstrual characteristics, symptoms, lifestyle behaviors, parental support, and awareness. Participants were classified into three risk strata for descriptive analysis; moderate- and high-risk groups were combined for logistic regression. Of 404 participants, 85 (21.0%) were classified as at-risk. Dose-response gradients were observed across strata for perceived stress, insufficient sleep, and parental indifference (all p < 0.05). The moderate-risk group had the highest rate of low awareness (84.8%). Insufficient sleep (AOR = 1.91, 95% CI: 1.17–3.11) and parental indifference (AOR = 2.55, 95% CI: 1.11–5.89) were independently associated with at-risk status. One in five rural adolescent girls reported PMOS-related risk symptoms, yet most lacked awareness. Insufficient sleep and parental indifference were independently associated with at-risk status and merit further investigation.