questions i have are, is it a stock heatsink/fan?
if so how do you feel about replacing it?
how long as this sound been going on for? (is it relatively new or has it been there since you've had the computer/ heatsink/fan?)
is the sound a consistent sound? or is it a varying sound? (as leedub suggested it COULD be bearings but more likely the fan is just loud)
in most cases when dealing with fan problems you will need to replace the fan anyway.
some cooling solutions for cpu's don't leave you with very many options other than replacing the heatsink altogether to fix a loud fan. zalman makes good quiet cooling solutions for cpu's and if you end up replacing your heatsink then that's what i would suggest.