I was on Orgovyx for 6 months. My testosterone went down to 16 and my PSA became undetectable. The side effects--occasional hot flashes, feeling tired--were very manageable and well worth it. My liver enzymes also increased: both ALT and AST to >100. My Urologist called part way through and suggested coming off Orgovyx because of this. BUT I consulted a liver specialist who assured me it was not a concern to have these increases temporarily. I continued Orgovyx. Now that it's done, my liver functions are back to normal. My treatment is at UCSF and I think the doctors are excellent. Bottom line is that you should consider seeing a liver specialist for advice about liver enzymes.