Hello, really sorry to hear that you are having such a tough time at the moment. I'm sorry that this might be a bit of a long reply, but I hope it is helpful.
When surgeons operate to remove endometriosis they are operating by eye and, although they do use magnification lenses to help them carry out laparoscopic surgery, they are often unable to remove tiny microscopic deposits or deep endometriosis that has permeated a patient's abdominal organs and GnRH Analogues/Agonists (like Prostap) are often prescribed to chemically shrink back any endometriosis left behind. This class of drugs suppress your body's production of oestrogen / progesterone and thereby your monthly cycle. This can bring relief from cyclic endometriosis symptoms because oestrogen feeds the growth of endometriosis. I've always thought about it a bit like tackling a garden overgrown with brambles - first you go in and cut everything you can see back with a hedge trimmer, then you apply weedkiller to the roots...
However, oestrogen does not just feed endometriosis, it is also plays an integral and invaluable role in many other of the body's processes. Consequently many of the side effects associated with Prostap / "GnRH Analogue/Agonist" treatment are associated with the hypoestrogenic (oestrogen-deficient) state "GnRH Analogues/Agonists" induce; including hot flushes, sleep disturbances, fatigue, potential loss of bone density, brain fog (memory problems/poor concentration), and significant mood changes (including depression and anxiety).
This is why many specialists prescribe Prostap along with a complementary dose of "add-back" HRT - the idea being to "add-back" just enough oestrogen to ease some of Prostap's more unpleasant side effects without reactivating the growth of Endometriosis. But as every women's body is unique and it can take a bit of experimentation to find the right "add-back" HRT dose - some women need just a low dose of HRT, while others find that their body requires a much higher dose of HRT "add-back". Similarly, some women find different brands and recipes of HRT suit them better than other - it is all sadly again just a case of trial and error until you find what works best for you.
Have you spoke to anyone about how you are feeling? GnRH Analogue/Agonist (Prostap) treatment is known to impact upon mood and it is important that you keep your specialist and also your GP informed about how you are feeling. Both should be able to offer you some emotional support to help you cope with the side effects of Prostap treatment, but if you feel that they are not up to speed with the neurological and physiological side effects that Prostap can induce then you need to refer them to the "Summary of Product Characteristics" published by the drug's manufacturer.
Prostap is manufactured by a company by Takeda Pharmaceuticals UK. You can download their published guidance regarding Protap's actions and side effects here:
Also, although they do not provide direct advice to patients, all of the big drug companies employ pharmacologists whose job it is to advise Specialists, GPs and other medical professionals about their products, the potential side effects of those products and how they can best help their patients in managing any side effects. Takeda Pharmaceuticals UK contact details can be found here:
Being prescribed a treatment to manage a condition is not the same as being prescribed a cure and it can be very difficult for the people around you - be they employers, friends, or loved ones - to keep that in mind. Every treatment, even the successful ones, can still have side effects that you may have to learn to accept and live with. It does sound as though you have a very supportive network of people around you, but if you are tired of struggling to find your own words to describe the impact Prostap is having upon your quality of sleep, and energy levels etc... then you could just print off the "Summary of Product Characteristics" and ask your employers, partner, family, and friends to read that too. Then maybe you won't feel that you need to make excuses about how you are feeling because you will know that they have concrete evidence from the manufacturer that what you are experiencing is not unusual?
Finally, have you ever been offered an Pelvic MRI? Like everything they have their strengths and weaknesses, but they can provide a very good picture of any deep infiltrating endometriosis that your specialist was not able to see / remove during your laparoscopy. It might be something to ask for? An MRI mapping any residual endometriosis and deep deposits should help your specialist assess any potential impact that might have upon your fertility and also serve as an invaluable resource for any future surgery.
Sorry that was such a very very long reply, but I hope it's a helpful one.