Hi dear, I have gone through your question and understand your concerns. Irregular bleeding and spotting can be due to hormonal disturbances, dysfunctional uterine bleeding, progesterone deficiency or local lesions in the cervix or vagina including cervical cancer. However, of your pap smear is negative, then chances of cervical cancer are ruled out. You should get your hormonal profile done, including thyroid hormone and prolactin levels, an ultrasound to see for any pathology in the uterus and an endometrial biopsy, if indicated, to confirm the diagnosis. Further management should be done accordingly. Hope you found the answer helpful. Regards Dr Deepti Verma OBGYN