There are side effects, mainly fatigue, but if you exercise daily it helps you feel better. The hot flashes are not that bad as they are short in duration.
I actually started ADT right after my biopsy results, as my Gleason score was 4+5. I then had the PSMA Scan about 2 weeks later. For stage 4, ADT is the first step in treatment. The side effects of ADT are nothing compared to what the cancer growths will do to your organs and bones. If I had not had my annual PSA test, I most likely would have died from kidney failure with out any treatment. My only symptoms were more frequent urination at night and some strange pains in my upper legs off and on.

someone might have already suggested this, however, I recommend to also use perplexity.ai. it costs $20 a month to use pro version. it is helpful by providing links to research papers (pud med articles) among other stuff. you can also copy paste test results and ask it to explain in lay man's terms. i found it very helpful.