Over time it causes the same issues as Lupron. Since it’s purposes to eliminate your testosterone, the side effects are due to low testosterone, not the drug itself.

Common side effects of very low testosterone
Hot flashes
Weakening of bones
Brain fog
Fatigue
Weight gain
Muscle deterioration

Stew80: at 72/73 I had RP, followed immediately by Salvage Radiation Treatment including 4 mos ADT; Orgovyx.

If ADT is for you, then I would suggest Orgovyx.

My primary side effect was fatigue; I called it a power reduction by 10 - 20 %. SEs dissipated 4+ mos post ADT.

And yes. I had some hot flushes and brain fog during treatment.

It seemed as if all of my age related issues became a bit more exacerbated by ADT.

Best wishes.

Not that bad Stew - others are worse. It will bring your T and PSA down FAST and put the brakes on your cancer’s activity.
There are some side effects, as others have mentioned, but forewarned is forearmed, right? Besides, Gleason 9 is aggressive and you need ADT to fight it. Best
Phil