It is time for ADT and you may need an ARSI as well. Something, your doctor will decide.

There is an alternative, it isn’t fully approved, but a lot of doctors will allow you to do it because it is very successful. The change is, you take estradiol patches instead of ADT and it reduces your testosterone but has many fewer side effects. They just finished a patch study that shows it is just as successful as ADT. I know someone who’s been doing it for many years. He now uses a gel, And gets tested regularly to make sure that he’s got the right level of estrogen in his body.