HRT (synthetic) and perimenopause symptoms

[Inge D]

Is it possible to be on birth control (the pill) and still experience perimenopause systems? You would think not in the first instance because you get the same dose of synthetic hormones every day of every month whereas the normal hormone production declines in perimenopause leading to specific symptoms.
But if you would think about the question in terms of hormone receptor sensitivity, could it be that – like in natural perimenopause where receptor sensitivity for estrogen and progesterone is declining – this happens also for synthetic hormones? So the question is more related to hormone receptors. In other words: do receptors react on synthetic hormones to same as natural hormones (although their chemical constitution is different) and so when receptor sensitivity declines, there is a possibility for women on birth control to also experience perimenopause symptoms like insomnia, anxiety, ... or maybe these things have not necessarily to do with hormone receptors but could be more related with these symptoms in link with aging in general?