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Rectal bleeding usually refers to bleeding from the anus, rectum, or colon, all of which are the final portions of the digestive tract. This type of bleeding is usually caused by haemorrhoids (piles) or anal fissure. A haemorrhoid is a swollen vein inside the anus. A fissure is a split in the lining of the anus. Both can be caused by constipation, and may cause difficult and painful bowel movements.
In most cases, postmenopausal bleeding is caused by issues such as endometrial atrophy (a thinning of the uterine lining), vaginal atrophy, fibroids, or endometrial polyps. The bleeding could also be a sign of endometrial cancer—a malignancy of the uterine lining, but only in a small number of cases.