Well, I worried about that before I had a diagnosis and especially when my neurologist suggested that I see a psychiatrist, but now that I'm essentially cured from PGAD, it's obvious that it wasn't in my head. Also, after communicating with a number of different physicians on the topic, they have confirmed that PGAD seems to be associated with pudendal neuralgia in many cases.
PNE since 2002. Started from weightlifting. PNE surgery from Dr. Bautrant, Oct 2004. Pain now is usually a 0 and I can sit for hours on certain chairs. No longer take medication for PNE. Can work full time and do "The Firm" exercise program. 99% cured from PGAD. PNE surgery was right for me but it might not be for you. Do your research.