I heard this expression, remembering it from growing up, an old neighborhood way of saying, so how the hell are ya, as if your balls were a barometer.
Since one thought inspires another, it then made me think of my beloved Italian Granddad who called balls, bollings. I remember when he rescued two black kittens, a male and female. He held up the little guy that fit right in his palm and said, “Susalina, see the bollings? He a’boy.”
Balls certainly have a place in our culture other than proper pants.
Balls to the wall meaning, with maximum effort, energy and speed.
Break your balls, by the balls, bust your balls.
Blue balls, big balls, Jerry Lee Lewis singing…Great Balls of fire.
One of JFK’s favorite expressions was: let’s grab our balls and go.
When he was about to debate Richard Nixon in 1960, his brother Bobby took him aside and said,” Kick-em’ in the balls Jack, kick’em in the balls.” I guess the Kennedys were just a balls kinda’ family, in more ways than one.
Sara Jessica Parker said, balls are to men what purses are to women.
The singer Joan Jett…Girls have got balls. They’re just a little higher up, that’s all.
There’s even a bad joke about Hillary Clinton: The reason Bill doesn’t like when she wears skirts, is because her balls show.
Yes, balls whether stuffed in a pair of chinos, Fruit of the Looms or a pair of pantyhose, make their point metaphorically or otherwise.
My personal favorite is when my pal Ed says, his balls are the size of the Capitol Dome.
Imagine putting your pants on over those. 
SB