I'm 60 and had pretty much the same diagnosis as you. I did SBRT (accelerated RT) and six months of ADT. I started with Lupron but had very bad mental side effects (depression, suicidal thoughts, forgetting names of people I'd known for years) so I switched to Orgovyx after two monthly Lupron injections and it was a lot better. It also has worn off much faster. I'm two months out from it now and feel no more effects from it while people in my support group who are on Lupron say it takes 3-6 months to return to normal after stopping.

If you are going to do ADT, I would suggest either Orgovyx (daily pill) or a MONTHLY injectable vs. the 3 or 6 month injectables because that way, if the side effects are too much for you, you can stop or switch to something else.

Note that only a couple other guys in my group got the same side effects as me. Others got physical side effects like hot flashes which I didn't get. So it seems everyone's side effects vary somewhat.