I've only been on ADT (Orgovyx) for a month and a half.

Ever since my RO sentenced me to 2 years of ADT I've wondered what I would do if my side effects became so severe I would want to stop.

When I discussed my current side effects with the doc who is supervising my ADT, he mentioned that the talk around the PCa department at his cancer center lately is the use of estrogen as an alternate ADT treatment. I was a bit astonished.

Here are some excerpts from "Transdermal Estrogen May Offer Another Option for ADT in Men With Metastatic Prostate Cancer" an article published this year in the ASCO Post https://dailynews.ascopubs.org/do/transdermal-estrogen-may-offer-another-option-adt-men-metastatic-prostate-cancer

“Estradiol patches may be a viable option for providing ADT to men with metastatic prostate cancer who are taking androgen receptor pathway inhibitors, according to new research being presented at the 2025 ASCO Genitourinary Cancers Symposium.

The findings, from a phase 2 study within the multiarm STAMPEDE trial, show that transdermal estradiol can achieve similar prostate-specific antigen responses as LHRHa in patients with metastatic disease, while limiting side effects.

Hot flashes and fatigue are among the most bothersome to patients, said lead author Nick James, PhD, MBBS, of the Institute of Cancer Research, The Royal Marsden NHS Foundation Trust, in London. In addition, he said, there is bone density loss that increases the risk of fragility fractures—particularly as a growing number of men with metastatic prostate cancer survive for years.

Transdermal estradiol, like that used for menopausal hormone therapy, is a potentially attractive alternative approach to ADT for a number of reasons, Dr. James said. It suppresses testosterone without estrogen depletion; it increases, rather than decreases, bone density; it’s inexpensive; and it avoids the blood clot risk associated with oral estrogen.....

...Estradiol patches could be particularly attractive to patients who are on an LHRHa and troubled by side effects like hot flashes, Dr. James said. But they also have appeal from a cost standpoint, he added, whether for health systems or, in places like the United States, for patients who lack insurance or are underinsured.

This sort of repurposing of an older, cheap drug, Dr. James said, is an important way to improve outcomes, separate from developing new drugs.”