To determine the impact of stroke on sexual life quality and to discuss the possible factors leading to its deterioration in stroke patients. Methods: Completed questionnaires were obtained from 49 of the 73 cerebral hemorrhage or cerebral infarction patients (ages between 18 and 55) in our out-hospital department from October 2014 to January 2015. Patient attitude towards sex and changes in sexual life condition before and after stroke was examined through questionnaires. Furthermore, patient medical records to investigate possible causes of sexual dysfunction were reviewed. Results: A majority of patients reported deterioration of quality of sexual life including a marked decline in libido, sexual frequency, erectile function in men, and vaginal lubrication in women. Patients also reported decreased satisfaction in and placing less importance on sexual life. Through comprehensive analysis, risk factors of sexual dysfunction were identified to be hypertension, use of hypertension drugs such as ACEI/ARBs, and anxiety about stroke recurrence. Conclusion: Sexual impairment in young to middle-aged post-stroke patients is common and related to many contributing factors.