Hello, I Am A 47 Yo Female Who Had A

Hello, I am a 47 yo female who had a hysterectomy in 2010. I still have my ovaries. I have had 5 large pregnancies. I was told my uterus was tilted backwards when I was a teen. Exercise, coughing, etc has always caused bladder leaks. Over the last 3-4 years, orgasmic contractions cause pain. The pain lasts days. I now have a partner after several years. This last weekend, my pain was especially strong. A 9 out of 10. Almost to tears. Similar to labor pains or menstrual cramps. I still have discomfort since Saturday. About a 3. Any ideas? Is it from disuse, like going to a gym and working out? Or something else?