Win32::OLE allows you to communicate directly with Word.

use Win32::OLE;
use Win32::OLE::Const "Microsoft Word 12.0 Object Library"; 
use Win32::OLE::Const "Microsoft Office 12.0 Object Library";

my $word = Win32::OLE->new( 'Word.Application', 'Quit' )
    or die "Can't create Word OLE: " . Win32::OLE->LastError . "\n";

$word->{'Visible'} = 1;

my $doc = $word->Documents->Add
    or die "Can't create new Word document: " . Win32::OLE->LastError 
+. "\n";

my $selection = $word->Selection; # select current position

$selection->{'Style'} = 'Title';
$selection->TypeText( 'Document title' );
$selection->TypeParagraph;

$selection->{'Style'} = 'Normal';
$selection->TypeText( 'Lorum ipsum' );
$selection->TypeParagraph;

$doc->SaveAs( 'foo.docx' );

$word->Quit;
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The Visual Basic for Applications examples you'll be able to find in the MSDN library for Office can mostly be simply converted to Win32::OLE Perl code by changing . to -> and a := b to { a => b }.