My RO and medical oncologist both minimized the problems with ADT and urged me to take it. I was mostly concerned about the hot flashes, fatigue and bone loss I'd heard about but went on it anyway. Then it dawned, T levels may never come back. I'm 76, and advancing age is a factor. High BMI is a factor that doesn't affect me. Anyway, the attached chart shows the kind of thing. If a patient is on ADT for 4 months he can expect rapid recovery. 12 months or 24 months on it and the recovery is slow and it flattens out more than the graph shows as time goes on.

The data is from several 2006 papers and one 2019 paper. I expect this is all Lupron data.

However, it is becoming acceptable for a patient off ADT to get testosterone therapy. What's the difference, if your testosterone recovers, you've got testosterone. If it doesn't, and you take testosterone, you've got testosterone. The idea clinicians have that its dangerous to take testosterone doesn't seem to make sense and apparently there is data showing this.