Background:There were few studies on the relation between changes in libido and incidence of stroke recurrence.The aim of this study was to investigate the relationship between libido decrease at 2 weeks after stroke and recurrent stroke at 1-year.Methods:It is a multi-centered,prospective cohort study.The 14th item of the Hamilton Depression Rating Scale-17 was used to evaluate changes of libido in poststroke patients at 2 weeks.Stroke recurrence was defined as an aggravation of former neurological functional deficit,new local or overall symptoms,or stroke diagnosed at re-admission.Results:Among 2341 enrolled patients,1757 patients had completed follow-up data,533 (30.34％) patients had decreased libido at 2 weeks,and 166 (9.45％) patients had recurrent stroke at 1-year.Multivariate logistic regression analysis showed that,compared with patients with normal libido,the odds ratio (OR) of recurrent stroke in patients with decreased libido was reduced by 41％ (OR =0.59,95％ confidence interval [CI]:0.40-0.87).The correlation was more prominent among male patients (OR =0.52,95％ CI:0.31-0.85) and patients of≥60 years of age (OR =0.57,95％ CI:0.35-0.93).Conclusions:One out of three stroke patients in mainland China has decreased libido at 2 weeks after stroke.Decreased libido is a protective factor for stroke recurrence at 1-year,which is more prominent among older male patients.