As the previous poster mentioned, if you remove the cooler (even better if you can remove the fan), you can then clean it really well with a cloth. If your fans are making a lot of noise now than in the past even after cleaning them, you may need to oil the bearings of the fan.
Also, yes, there is a chance you may need to change the thermal paste because it can dry up but that usually happens after many years (5-10+) though I haven't replaced my thermal paste in 8 years here and my temperatures are still pretty good (depends on the thermal paste quality).
I used an air compressor machine to clean the fans of my PC (overkill) but very effective.