After falling behind two dangerous riders in Monday's hectic finale, Annemiek van Vleuten's Tour de France Femmes hopes took an even more worrisome turn on stage three.

The Dutchwoman, a pre-race favorite to win the overall, reached the finish line with her shoulders shaking on the steep Epernay slope and crossed the road to limit her losses.

The reason turned out to be illness. Cycling News saw Van Vleuten mention her stomach ailment when she returned to the bus in Movistar and spoke with team staff. She refused to speak to reporters there, but later offered an explanation through the team.

"It started two hours after the first stage (on Sunday). I couldn't eat, I couldn't drink, I was so tired. I felt empty."

"Yesterday I felt very bad, but to finish the stage like that was a victory. Today was the first time I had a normal breakfast, so I thought I would be okay, but I paid the price for not feeling well for 24 hours."

Eurosport's Iris Slappendel, commentating from her bike during the race, reported that she saw Van Vleuten stop for a "much needed" natural break during the stage.

Still, Van Vleuten was strong enough to make the crucial choice to cross the Côte de Mutigny with 15 km to go in a punchy finale in the Champagne Hills. However, he struggled on the Mont Vernon climb with 5km to go and dropped out of the lead group of more than a dozen riders.

The Giro Donne champion managed to recover, but when the slope to the finish kicked up with 350 meters to go, she was again separated.

She finished 10th, 20 seconds behind stage winner Cecilie Uttrup-Ludwig (FDJ-Suez-Futuroscope) and 18 seconds behind the race leaders, Marianne Vos (Jumbo-Visma), Ashley Mourman-Pasio (SD Works), Silvia Persico (Valcar Travel & Service), Elisa Longo Borghini (Trek Segafredo), and Katarzyna Nieviadoma (Canyon SRAM) were also 18 seconds behind.

"Yesterday we played poker, but today we couldn't play poker anymore," Van Vleuten said.

"It was a thousand times better than yesterday. But I still didn't feel okay. I couldn't keep up on the last climb. But I was still okay on the first climb, so I think that's a sign that I'm getting better."

Despite moving up to ninth overall, Van Vleuten was 1:14 behind Vos' lead and less than a minute behind Longo Borghini and Niwi Adma, who took 30 seconds off late in the second stage. Longo Borghini and Niewiadoma also took a 30-second lead at the end of stage 2. Still, given her problems, the result could have been much worse.

"I lost a little time again, but when I woke up yesterday I wasn't thinking about finishing the race. Now I'm still in the race and I'm getting better and better, so I'm happy for now."

"You can't control it. What I can control is to focus on getting better.