That's how things are with Strawberry—just use CPAN and things Just Work.
Same with ActiveState. Like I above, cpan Module. It'll install dmake and mingw if no compiler is found.
With ActiveState, unless they've changed things in the past two years, you need to have Visual C and nmake installed (which I don't)
You don't need this, but it's a free one-click install if you want to use it.
AS does have ppm,but—at least the version I have (5.10)—it's horrible.
I used ppm with 5.10 for a long time. It's great. I rarely had to leave it. Are you just using the AS repo, or did you check the others?