Instead of concluding you are suffering from "all the usual problems with ADT" you might want to consider thinking you are suffering from "all the usual problems with the particular ADT drug you have been prescribed".

Dr. Paul Schellhammer, former president of AUA, has been using an alternate drug, trans-dermal estradiol, a.k.a. tE2, for 20 or so years. Estradiol has the same effect on testosterone as the more traditional drugs used for ADT.

Most of the "usual problems with ADT" are eliminated. The main drawback is that compared to the fairly low 3 - 15% rate of breast development or breast pain in patients on Lupron, up to 85% of patients experience these problems while on tE2. See the attached photo of Paul Wassersug displaying what happens to most of these 85%..

Schellhammer was interviewed by Mark Moyad of P.C.R.I. recently. Starting at minute 51:30 in this video the discussion turned to tE2. https://www.youtube.com/watch

UCSF is putting on a webinar August 20 moderated by Dr. Matthew Cooperberg "Transdermal estradiol vs traditional ADT – what’s best for you?" https://meded.ucsf.edu/events/6th-urotoday-journal-club-prostate-cancer-patients

The reason new attention is focused on tE2 is the publication of the groundbreaking study recently published in the New England Journal of Medicine comparing traditional ADT (Lupron, Orgovyx, Firmagon, etc.) with Transdermal Estradiol therapy. https://www.nejm.org/doi/full/10.1056/NEJMoa2511781