The adrenal cortex helps to maintain the water and sodium homeostasis (balance) within the body; it also contributes to carbohydrate metabolism and the regulation of blood sugar. The adrenal cortex further produces a sex hormone similar to that secreted by the testes. The medulla of the adrenal gland produces the hormone epinephrine, also called adrenaline, when the body is under stress; this hormone speeds up the rate of metabolism in order to help it cope with stressful situations. The performance of the adrenal glands is most often impaired due to extensive use of cortisone therapy for nonendocrine diseases, such as arthritis and asthma. Long-term use of cortisone drugs also causes the adrenal gland to shrink in size. Pituitary disease and tuberculosis also lead to adrenocortical failure.