Got large after market coolers on 2 of my rigs. Even though I am not overclocking on one of them I can run the large fan much slower (one of them hardly even comes on) which helps with noise.
I remember when I built a rig out of spare parts I had about 2 years ago. Athlon XP (Socket A) processor. No Q-fan or anything like that. I have no idea how I coped with those things before. It sounded like a hairdryer!