I've been using Perl (both Activestate and now Strawberry only) on Windows 7 x64 for 2+ years. I started with Activestate and then moved to Strawberry 5.10.1. I'm now at 5.12.3 but have also tested 5.14.x.
I use some non-core modules and all installed without issues. I used the patches to get Net::Pcap to compile and work and even got Tk to compile with a little Google search (one line fix in a header file). I've only used the DBI modules for testing connectivity to an MS Access database and that didn't work for me when I moved from Windows XP 32-bit w/ Strawberry to Windows 7 64-bit w/ Strawberry. I suspect it has to do with the ODBC 32-bit/64-bit EXE and since it was only a test for me, I didn't pursue it.
I also do some IPv6 work and found that although core module Socket should have IPv6 support as of 5.14 - it doesn't on Windows, even though Windows will support the get*info() functions as evidence C programs which I wrote to test and they compiled fine with the gcc provided with Strawberry (and a header file tweak). I needed to install Socket::GetAddrInfo to get IPv6 working.