Hello, As you have reached the age at which perimenopause and/or menopause happen in the majority, hormonal imbalance is a common observation. If you have had regular normal pap smear tests, you need not worry much about cervical cancer possibility. What is more likely in this scenario is an abnormal endometrial pattern, perhaps leading to breakthrough bleeding. An endometrial biopsy, colposcopy and a trans-vaginal sonogram are needed. Your symptoms are suggestive of an impending period. Please get further evaluation from an expert in person. Take care.