First, you should totally exclude Lupron because once you are jabbed you are stuck in more ways than one even with severe side effects. Also, limit to 4 months. Do they even know if it should be adjuvant (post) neoadjuvant (pre) or current? Recent studies have shown that adjuvant provides better results. If that is the case, you can agree and decide after treatment if you should take the Orgovyx. With Orgovyx you can also stop at any time. It will take 4-8 weeks after stopping for testosterone to return.

I had Orgovyx without extraneous side effects (hot flashes, night sweats, etc.) but more than 50% taking Orgovyx (higher on Lupron) report these symptoms so you might not be so lucky. Anyone on ADT will need to do resistance training and take calcium supplements to minimize bone and muscle loss. I had no muscle loss, and bone loss was minimal (DeXA scans pre and post). What cannot be controlled is shrinking of testes and failure of testosterone to return to base levels. At your age you can expect a permanent decrease in testosterone levels. Check total testosterone pretreatment and see if you have a 25% buffer to lose post treatment. It could be either less or more. It is unlikely that you will not get most of the baseline testosterone level back (65%-80%) but becomes fairly common in late 70s or older for ADT to cause 50%-80% loss from baseline.