I know that no one, like NO ONE, actually wants to be on ADT. There are a lot of downsides to it, and complaints about the fatigue, lack of sex drive, etc. are a common theme on this forum.
I'm about a year out now from starting on Zoladex shots (a drug that works in the same way as Lupron), and I wanted to post about what I found to be some actual GOOD things about being on this stuff:
#1 - I'M NOT DEAD: Ok this is the most obvious one. When I got my diagnosis in October of 2022, I thought I was a dead man walking. I was metastatic with at least 13 tumors (including a massive 6cm primary and 5 bone mets), and my sister had died in '21 from metastasic cervical cancer with only 3 mets. Debilitating radiation, chemo treatments, and an immunotherapy clinical trial barely slowed the cancer down for her, and she was taken from us far too soon.
In my case though, after starting ADT on November 25th with a PSA of 104, by January 14th my PSA was a mere 1.4. I felt the lymph node met popping out on my left groin melt away after just over 3 weeks, with those inside my body probably reducing similarly as well. Eventually Darolutamide and Taxotere chemo would be added to bring that PSA down to 0.0, but in doing the obvious math the ADT clearly did all the heavy lifting.
Bottom line, most of us are extremely fortunate to have a cancer that responds well to ADT. ADT is like the ultimate cheat code in a really shitty video game, where the final boss is unbeatable and you only have one life.
#2 - I get along better with people: I've generally been pretty on edge for most of my adult life, and I'd chalked it up to the stress of working in emergency services for 25 years. When my cancer hit and I had my testosterone checked for the first time ever, it read at 800+ ng/dl at age 48. This is in the high range for men of any age, and it explained a lot. Since it's been brought down to rock bottom by ADT, I've found myself to be much...nicer. I can empathize with people better, and deal with them on a more "feminine" level, for lack of a better term. For sure I get the occasional mood swings and sad day, but this is balanced out by being much easier to get along with (especially with my family).
#3: Lower sex drive. While most men might see this as a negative, I can say it's changed my marriage for the better. When I married Mrs. 32Percenter my high-T raging libido was much more intense than hers, and this disparity only grew over 11 years of child-raising and familiarity. As you can imagine this led to problems - problems that fast became irrelevant thanks to ADT bringing my drive down closer to Mrs. 32Percenter's current level. We're now intimate a couple times a month, and it's fun and light rather than aggressive as in the past, where getting off was usually my primary goal (and I can still do it without pills for now, knock on wood).
Then there's that old stat about men thinking about sex about every 3 seconds. I have to say that since ADT this isn't a thing, and much of my brainpower and concentration has been freed up to focus on other important things.
#4: Still not dead! Yeah I know I mentioned this before, but I think it's crucial enough that it should be mentioned on a second go.
#5 - Mellowing out on physical stressors: Having the testosterone level of a teen in a body approaching 50 years of age is like putting a Ferrari engine in an old K-car, with similar results. I was mistreating my body well into my 40s, doing things like obstacle course races, pushing too much weight in the gym, skipping out on sleep too often, and working night shifts alongside all the younger folks I work with. After a year of ADT, if I do ANY of those things my body reminds me that it was a very bad idea, and I have to force myself to take it easier and pull back. Recovery from physical stress just isn't the same, but this isn't necessarily a bad thing - without the moderation brakes on it's easy to wreck your joints and your adrenals (my first bone scan was a rude awakening of how many of my joints are almost toast at only the mid-life point).
Don't get me wrong, despite this list, if I can ever get off these drugs I'd do it without a second's hesitation. But I have to say that in the big picture everything isn't ALL bad. I also wanted to put this post together to show anyone about to go on ADT that there may be some positives in the experience for them as well. Especially the "not dying" part!
First post-ADT followup. So far so good ... but it's early
ADT + Chemo vs ADT followed by Chemo
Importance of ADT
PSA Anxiety and Intermittent ADT for Metastatic Prostate Cancer 
