If the card is running at 100% load when gaming (or thereabout) then I would up the fan curve.
I have my fan curve set to 10% higher than what the temp is - 30*C at 40% - 50*C at 60% etc. Once the GPU exceeds 50*C though I up the fan straight to 100%. I usually game with headphones and the reference cooler on my GPU isn't too loud anyway.
