This is an area of *extremely* active research right now, for people at all stages of prostate cancer (I'm currently an ADT "lifer" because I'm at stage 4). Expect the recommendations to change rapidly, even every few months, until there's a consensus on how to react to all the new studies coming out.

Interestingly, the challenge is that they're much better at keeping us alive now, even with advanced prostate cancer, so suddenly the long-term risks of ADT — type 2 diabetes, osteoporosis, cardiovascular disease, etc. — have become a concern. This is what progress looks like, in all its messy glory.