Just wanted to update on this.
After weeks of my GPU being super loud and my hotspot peaking out at 105 degrees I finally got MSI Afterburner and learnt how to undervolt. The Youtube video I watched recommended setting a 200 Mhz underclock and then raising the voltage at 825 to I believe 1800 mhz.
Anyway, it has definitely helped. My hotspot now peaks at 100, which is when the fans kick in, cooling it to 98 and the fans quieten down again, for a few minutes until coming back on again for a few seconds if it goes over 100 again. It’s a huge improvement in fan noise if only a 3 or 4 degree drop in hotspot temp.
Weirdly, my 3D Mark benchmark scores have actually improved slightly, which I guess is due to the fact I must have been thermal throttling before.
This is definitely a massive win for me, it seems stable, MSFS performance is great and everything is so much quieter. Definitely recommend undervolting if you are having hot spot temp issues like me.